Primary musculoskeletal neoplasms: effectiveness of core-needle biopsy.
OBJECTIVE
To analyze the effectiveness of core-needle biopsy for evaluation of possible primary musculoskeletal neoplasms, which often are evaluated with open biopsy.


METHODS
Core-needle biopsy was performed at a tertiary care institution in 141 patients suspected of having a mesenchymal neoplasm. In 85 patients, the lesion was in soft tissue; in 56 patients, the lesion was in bone. Eighty-nine patients had a malignant lesion, and 52 had a benign lesion. Twenty-eight patients had undergone previous surgery.


RESULTS
In 105 (74%) patients, core-needle biopsy results were concordant with results from specimens subsequently obtained at surgery with respect to tumor histologic features and grade, or they provided sufficient diagnostic information to obviate surgery. In 36 (26%) patients, inaccurate core-needle biopsy results were obtained: In nine, results were imprecise about exact histologic features; in three, results were correct about histologic features but incorrect about tumor grade. In 25 (18%) patients, open biopsy was performed after core-needle biopsy. The accuracy and rate of performance of open biopsy for soft-tissue lesions were not significantly different from those for bone lesions.


CONCLUSIONS
Percutaneous core-needle biopsy can be an effective alternative to open biopsy in the evaluation of possible mesenchymal neoplasms of either bone or soft tissue. Needle biopsy of such lesions, however, is best performed as part of a multidisciplinary team approach to tumor management.
Yao
L
L
Department of Radiology, Georgetown University Medical Center, Washington, DC 20007, USA. yaol@gunet.georgetown.edu
Nelson
S D
SD
Seeger
L L
LL
Eckardt
J J
JJ
Eilber
F R
FR
D001706:Biopsy; D001707:Biopsy, Needle; D001859:Bone Neoplasms / Q000473:pathology*; D001842:Bone and Bones / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D008637:Mesenchymoma / Q000473:pathology; D019042:Muscle Neoplasms / Q000473:pathology*; D009132:Muscles / Q000473:pathology; D012680:Sensitivity and Specificity; D012983:Soft Tissue Neoplasms / Q000473:pathology