Needle biopsy of bone and soft tissue tumors

The classification and diagnosis of bone and soft tissue tumors are extremely complicated. It is difficult to make a correct diagnosis solely relying on clinical examination and imaging. Biopsy is a necessary way to diagnose most bone and soft tissue tumors. Biopsy is divided into needle biopsy and open biopsy.

Needle biopsy is to use a thick trocar to take out about 0.3*0.3*1cm of tissue and send it for pathological diagnosis. The thick trocar puncture is best performed in a hospital with a large number of bone and soft tissue tumors. Only experienced doctors can get the tumor tissue, and the design of the puncture needle path must be consistent with the surgical approach before it can be removed during the operation. Therefore, foreign countries advocate that the chief surgeon design the puncture needle path. The puncture pathological diagnosis is very difficult and the sample size is small. The diagnosis depends on experts with rich experience in bone and soft tissue tumor pathology. Diagnosis of difficult pathology often requires discussions with bone and soft tissue tumor specialists, pathologists, and radiologists. In the Bone and Soft Tissue Tumor Center of Sun Yat-sen University, the accuracy rate of needle biopsy diagnosis is more than 90%. In the 1980s, a professional thick trocar was designed, and a wealth of clinical experience has been accumulated. It is often used in the diagnosis of benign tumors, such as ossifying fibroma, aneurysmal bone cyst, osteoblastoma, giant cell tumor of bone, lipoma, schwannoma, etc., malignant tumors: such as osteosarcoma, metastatic tumor, malignant tumor Diagnosis of fibrohistiocytosis, fibrosarcoma, synovial sarcoma, leiomyosarcoma, etc. The operation time is less than 20 minutes, and the surgical incision is about 0.3 cm. It can be carried out under local anesthesia. It also has the advantages of low cost, less trauma, and quick recovery. Chemotherapy drugs that kill tumor cells can be applied the next day after the puncture.

Incision biopsy is usually performed after the failure of the biopsy. The incision is about 6-8cm. The wound is large and the recovery is slower. However, there are more pathological tissues collected, which is helpful for the pathologist to make a comprehensive diagnosis. Chemotherapy can be given only two weeks after the puncture. Incision biopsy also has many technical details. For example, the incision design must be removed during the second operation, there is no tumor during the operation, and proper drainage after the operation to prevent hematoma. It is a pity that some basic-level hospitals have carried out incision biopsy, which brings difficulties to the second limb salvage surgery for extensive tumor resection, and the patient loses the opportunity to salvage limbs.

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