Authors: Sheila C Adams Benjamin K Potter David J Pitcher H Thomas Temple
Publish Date: 2010/06/26
Volume: 468, Issue: 10, Pages: 2774-2780
Abstract
Biopsy is a critical step in the diagnosis of musculoskeletal malignancy As an alternative to open biopsy percutaneous core needle biopsy techniques have been developed As many studies combine officebased imageguided and operative biopsies the accuracy of officebased core needle biopsy is not well documentedWe asked whether 1 officebased core needle biopsy for the diagnosis of malignant musculoskeletal neoplasms would have few complications and diagnostic and accuracy rates comparable to those cited in the literature for core needle biopsy 2 diagnostic errors related to officebased core needle biopsy would result in surgical treatment errors and 3 tissue core quantity and tumor type would affect accuracyWe retrospectively reviewed 234 patients with 252 core needle biopsies of malignant bone and soft tissue neoplasms at one institution between 1999 and 2007 Biopsy accuracy and errors were determined on the basis of histologic evaluation of prior or subsequent biopsies and/or resected specimens when available We eliminated 19 patients who had needle biopsies three had the core needle biopsy completed in the operating room and 16 had insufficient documentation or followup leaving 233 for studyOf the 233 core needle biopsies 212 91 were diagnostic and accurate for malignancy Fourteen 6 biopsies were nondiagnostic Major errors defined as a benign diagnosis in a malignant tumor occurred in seven cases 3 Minor errors defined as errors in histopathologic diagnosis or grade occurred in 24 biopsies 10 All nondiagnostic and major core needle biopsy errors were identified and addressed with either a diagnostic open biopsy or definitive wide local excision resulting in no surgical treatment errors Accuracy was not influenced by core number however myxoid lesions showed a correlation with biopsy error There were no biopsyrelated complications
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