Biopsy of musculoskeletal tumors

Waleed Awwad, MD, FRCSC

Introduction

Critical procedure. Influence on the outcome. Methodology. Physician performing the biopsy. Malignant soft tissue and bone tumors. Treatment of patients. Biopsy is performed.

Imaging

Most commonly used imaging. Information from imaging: - Anatomic localization. - Vital structures. - Area most appropriate for biopsy. - Choice of technique.

Principles of biopsy

Performed. Minimize contamination. - Deep lesions.

- Approaches. - Healthy skin. - Biopsy tract. - Meticulous hemostasis: closed biopsy, open soft tissue and

bone.

Incision orientation.

Principles of biopsy

Principles of biopsy

Principles of biopsy Biopsy types: > Closed. > Open.

Percutaneous technique

Imaging is needed or Not. Type and size of biopsy needle.

Percutaneous technique

Percutaneous technique

Fine needle aspiration (FNA): - Most appropriate. - Material aspirated. - Advantage. - Disadvantage. - Results.

Percutaneous technique

Core needle biopsy.

- Needle gauge. - Tissue sample and architecture. - Advantages. - Disadvantages. - Results.

Open techniques

Incisional biopsy:

- Gold standard. - Despite this fact. - Advantage. - Disadvantage. - Results.

Open techniques

Open techniques

Excisional biopsy:

- Used. - Advantages. - Disadvantages.

Summary

Biopsy has a big impact. Biopsy plane. Closed biopsy techniques. Radiologist and pathologist. Physician performing the definitive

treatment.

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