Early and Late Complications of Percutaneous Core Needle Biopsy of Retroperitoneal Tumors at Two Tertiary Sarcoma Centers

  • David Berger-RichardsonEmail author
  • Sally M. Burtenshaw
  • Andrea M. Ibrahim
  • Rebecca A. Gladdy
  • Rebecca Auer
  • Rob Beecroft
  • Brendan C. Dickson
  • Bibianna Purgina
  • Kristin Ambacher
  • Carolyn Nessim
  • Carol J. Swallow



Concern persists regarding percutaneous core needle biopsy (CNB) of a potentially malignant lesion of the retroperitoneum due to the perceived risk of immediate complications and adverse oncologic outcomes, including needle tract seeding (NTS).


The aim of this study was to evaluate the incidence of (1) early complications and (2) NTS following CNB of suspected retroperitoneal sarcoma (RPS).


Patients who underwent CNB of an RP mass with pre-biopsy suspicion of sarcoma were identified from a prospective database at two centers: (1) Princess Margaret Cancer Centre/Mount Sinai Hospital, Toronto (2009–2015); and (2) The Ottawa Hospital (1999–2015). Early complications, including bleeding, pain, infection, and organ injury, were recorded. Instances of NTS were identified from long-term follow-up of patients who underwent resection of primary RPS at these two centers after initial CNB (1996–2013).


Of 358 percutaneous CNBs of suspected RPS performed over the study period, 7 (2.0%) resulted in minor bleeding with no transfusion, 3 (0.8%) resulted in significant pain, 1 (0.3%) resulted in unplanned admission to hospital for observation, and 1 (0.3%) resulted in a pneumothorax. There were no infections. In 203 patients who underwent resection of RPS following CNB, crude cumulative local recurrence was 24% at 5 years. At a median follow-up of 44 months, there was one case of NTS (approximately 0.5%).


This large bi-institutional experience with CNB of an RP mass demonstrates that both the early complication rate and the incidence of NTS are very low. Physicians and patients can be reassured that the benefits of CNB in diagnosing sarcoma and determining its histologic subtype and grade far outweigh the risks.



The Jim Chamberlain Fund, Princess Margaret Cancer Centre.


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Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  • David Berger-Richardson
    • 1
    • 2
    Email author
  • Sally M. Burtenshaw
    • 3
    • 4
  • Andrea M. Ibrahim
    • 5
  • Rebecca A. Gladdy
    • 1
    • 2
    • 3
    • 4
  • Rebecca Auer
    • 5
    • 6
    • 7
  • Rob Beecroft
    • 8
  • Brendan C. Dickson
    • 9
  • Bibianna Purgina
    • 10
  • Kristin Ambacher
    • 5
  • Carolyn Nessim
    • 5
    • 6
    • 7
  • Carol J. Swallow
    • 1
    • 2
    • 3
    • 4
  1. 1.Department of SurgeryUniversity of TorontoTorontoCanada
  2. 2.Lunenfeld Tanenbaum Research InstituteMount Sinai HospitalTorontoCanada
  3. 3.Division of General SurgeryMount Sinai HospitalTorontoCanada
  4. 4.Department of Surgical Oncology, Princess Margaret Cancer CentreUniversity Health Network and Sinai Health SystemTorontoCanada
  5. 5.The Ottawa Hospital Research InstituteOttawaCanada
  6. 6.Department of SurgeryUniversity of OttawaOttawaCanada
  7. 7.Division of General SurgeryThe Ottawa HospitalOttawaCanada
  8. 8.Joint Department of Medical Imaging, Mount Sinai Hospital and University Health NetworkUniversity of TorontoTorontoCanada
  9. 9.Department of Pathology and Laboratory MedicineMount Sinai Hospital and University of TorontoTorontoCanada
  10. 10.Department of Pathology and Laboratory MedicineThe Ottawa HospitalOttawaCanada

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