Fine-needle aspiration cytology and core needle biopsy in the preoperative diagnosis of desmoid tumors.
BACKGROUND
Desmoid tumors have a tendency to recur locally, and traditionally they have been treated surgically. No treatment is sometimes indicated, however; this requires a morphological diagnosis that is not based on a surgical specimen. In this study we aimed to identify the diagnostic accuracy of needle and core biopsy for the morphological diagnosis of desmoid.


METHODS
We compared the diagnostic accuracy of fine-needle aspiration (FNA) and core needle biopsy (CNB) in 69 and 26 patients, respectively, who had had surgical resections for desmoid. We also reviewed 15 additional cases that had been incorrectly diagnosed as desmoid on FNA but which had different diagnoses after surgery.


RESULTS
FNA-based diagnoses of desmoid/fibromatosis were rendered in 35 of 69 cases, and other benign spindle cell proliferations in 26 cases and spindle cell sarcoma in the remaining 4 cases. All 26 CNBs were either suggested to correspond to desmoid (24) or other benign spindle cell lesions (2). Of the 15 FNAs incorrectly diagnosed as desmoid, 2 were found to be sarcomas.


CONCLUSIONS
FNA is fairly reliable for recognition of the benign nature of desmoids. Occasional over- and under-diagnosis of malignancy can occur, however. CNB appears to be more reliable.
Dalén
B P Mikael
BP
Department of Orthopaedics, Sahlgrenska University Hospital, Göteborg, Sweden. mikael.dalen@vgregion.se
Meis-Kindblom
Jeanne M
JM
Sumathi
Vaiyapuri P
VP
Ryd
Walter
W
Kindblom
Lars-Gunnar
LG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D001707:Biopsy, Needle; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D018221:Fibromatosis, Abdominal / Q000473:pathology* / Q000601:surgery; D018222:Desmoid Tumors / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012983:Soft Tissue Neoplasms / Q000473:pathology* / Q000601:surgery