How Should Musculoskeletal Biopsies Be Performed?

Mavrogenis, Andreas F.; Angelini, Andrea; Errani, Costantino; Rimondi, Eugenio

doi:10.3928/01477447-20140825-03

Cited by 25 publications

(17 citation statements)

References 19 publications

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“…The goal of biopsy is to obtain a diagnostic tissue sample without complications, tumor spread, and compromise of future treatments. As a rule, all lesions should be biopsied as if they were malignant [ 35 , 36 ]. Traditionally, open biopsy has been the biopsy technique of choice for musculoskeletal tumors, providing adequate material for histological and immunohistochemical studies, resulting in a higher rate of accuracy compared with closed biopsy.…”

Section: Diagnosismentioning

confidence: 99%

“…Imaging-guided closed biopsy increases the accuracy and reduces the risk of complications of the biopsy, especially for deep-seated tumors. An open biopsy is indicated when (1) a repeat closed biopsy is not diagnostic or is inconclusive, (2) an adequate tissue sample cannot be obtained with closed biopsy, and (3) the result of closed biopsy does not correlate with the clinical presentation and imaging findings [ 35 , 36 ].…”

Section: Diagnosismentioning

confidence: 99%

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Giant cell tumor of bone revisited

Mavrogenis

Igoumenou

Megaloikonomos

et al. 2017

SICOT-J

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117

135

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Giant cell tumor (GCT) of bone is a locally aggressive benign neoplasm that is associated with a large biological spectrum ranging from latent benign to highly recurrent and occasionally metastatic malignant bone tumor. It accounts for 4–10% of all bone tumors and typically affects the meta-epiphyseal region of long bones of young adults. The most common site involved is the distal femur, followed by the distal radius, sacrum, and proximal humerus. Clinical symptoms are nonspecific and may include local pain, swelling, and limited range of motion of the adjacent joint. Radiographs and contrast-enhanced magnetic resonance imaging (MRI) are the imaging modalities of choice for diagnosis. Surgical treatment with curettage is the optimal treatment for local tumor control. A favorable clinical outcome is expected when the tumor is excised to tumor-free margins, however, for periarticular lesions this is usually accompanied with a suboptimal functional outcome. Local adjuvants have been used for improved curettage, in addition to systematic agents such as denosumab, bisphosphonates, or interferon alpha. This article aims to discuss the clinicopathological features, diagnosis, and treatments for GCT of bone.

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Section: Diagnosismentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

Giant cell tumor of bone revisited

Mavrogenis

Igoumenou

Megaloikonomos

et al. 2017

SICOT-J

Self Cite

117

135

View full text Add to dashboard Cite

show abstract

“…The multidisciplinary team should be included in management of the biopsy and always consist of at least an MSK radiologist, orthopaedic sarcoma surgeon, and pathologist. 6,30 Previous imaging has to be obtained and discussed at the oncology conference. US is an initial imaging method of choice for soft tissue tumor evaluation, as long as the lesion is assessable, 31 whereas plain radiograph is the primary imaging modality for bone lesion assessment.…”

Section: Preparation For Biopsymentioning

confidence: 99%

“…several important benefits, such as obtaining large tissue specimens that are sufficient for all cytological and histopathologic analyses, and a high diagnostic accuracy approaching almost 100% in selected groups of patients. 2,5,6 Nevertheless, some difficulties and disadvantages are associated with open biopsy including a higher rate of complications in up to 16% that can modify the treatment strategy in 8% of the cases, more severe complications, possibility of infection, dehiscence of the wound, possibility of profuse bleeding, and formation of hematoma that can facilitate tumor seeding. 2,[7][8][9] The errors in diagnosis associated with open biopsy can jeopardize limbsparing surgery and lead to otherwise unnecessary limb amputations in 1.2% of the cases.…”

mentioning

confidence: 99%

Percutaneous Imaging-Guided versus Open Musculoskeletal Biopsy: Concepts and Controversies

Nikodinovska

Ivanoski

Samardziski

et al. 2020

Semin Musculoskelet Radiol

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Bone and soft tissue tumors are a largely heterogeneous group of tumors. Biopsy of musculoskeletal (MSK) tumors is sometimes a challenging procedure. Although the open biopsy is still considered the gold standard for the biopsy of MSK lesions, core needle biopsy can replace it in most cases, with similar accuracy and a low complication rate. The biopsy should be performed in a tertiary sarcoma center where the multidisciplinary team consists of at minimum a tumor surgeon, an MSK pathologist, and an MSK radiologist who can assess all steps of the procedure. Several factors can influence the success of the biopsy including the lesion characteristics, the equipment, and the method used for the procedure. This review highlights some of the important aspects regarding the biopsy of the MSK tumors, with special attention to imaging a guided core needle biopsy and highlighting some of the recent advancements and controversies in the field.

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“…The biopsy must be carefully planned with an understanding of the orthopedic surgeon's perspective, and the optimal biopsy tract should be chosen after considering the location, size, and morphological features of the lesion. It is better to use a shorter path to the lesion, although the shortest distance to the lesion is not necessarily the optimal route ( 4 ). The biopsy tract must be placed within the surgical resection margins because the en bloc resection of the tumor, as well as the biopsy tract, is needed to avoid possible tumor seeding along the tract.…”

Section: Selecting a Proper Biopsy Routementioning

confidence: 99%

Practical Guidelines for Ultrasound-Guided Core Needle Biopsy of Soft-Tissue Lesions: Transformation from Beginner to Specialist

Kim

Chung

et al. 2017

Korean J Radiol

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Ultrasound-guided core needle biopsy (US-CNB) is an important step in the diagnosis of musculoskeletal soft-tissue lesions. To maximize efficacy and minimize the complications of US-CNB, it is critical to collaborate with a multidisciplinary team and to understand the particular considerations of US-CNB for these lesions. The purpose of this article is to provide a systematic review and step-by-step tips for using US-CNB to diagnose musculoskeletal soft-tissue lesions.

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How Should Musculoskeletal Biopsies Be Performed?

Cited by 25 publications

References 19 publications

Giant cell tumor of bone revisited

Giant cell tumor of bone revisited

Percutaneous Imaging-Guided versus Open Musculoskeletal Biopsy: Concepts and Controversies

Practical Guidelines for Ultrasound-Guided Core Needle Biopsy of Soft-Tissue Lesions: Transformation from Beginner to Specialist

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