Die transrektale ultraschallassistierte Stanzbiopsie in der Diagnostik des präsakralen Rektumkarzinomrezidivs

Abstract

Suspected extraluminal recurrence of rectal carcinoma after surgical treatment represents a frequent diagnostic challenge. Clinical history and examination as well as tomographic imaging often do not equivocally settle this tissue. Glucose-PET is an expensive, not universally available test. Early diagnosis is required for both successful operative reintervention aiming at cure and indication to palliative therapy. We performed gun-biopsy of presacral space-occupying lesions in three patients, choosing the ultrasound-guided transrectal approach in three of them. Extraluminal recurrence was proven in one patient. In another patient, anastomotic recurrence was proven by endoscopic biopsy and presacral recurrence ruled out before reoperation. In the third patient, no tumour tissue was found in the samples, as confirmed by his clinical course and by another biopsy after one year. By providing a sufficient amount of tissue for histological examination, ultrasound-guided gun-biopsy allows definite diagnosis in presacral space-occupying lesions and hence represents an important expansion of the diagnostic repertoire in the follow-up of rectal cancer.