Saghieh Said, Masrouha Karim Z, Musallam Khaled M, Mahfouz Rami, Abboud Miguel, Khoury Nabil J, Haidar Rachid
Department of Surgery, Division of Orthopaedic Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
Iowa Orthop J. 2010;30:80-3.
We evaluated the local recurrence rate (LRR) of bone sarcoma along the core-needle biopsy (CNB) tract in patients who underwent limb Salvage Surgery (LSS) following a diagnostic CNB performed irrespective of the planned surgical incision site and for which surgery did not involve any biopsy tract removal.
A retrospective review of 10 pediatric patients diagnosed with bone sarcoma using a computed tomography-guided core-needle biopsy, with evaluation of medical records, pathological specimens and radiological films from the date of diagnosis until the most recent follow-up.
None of the patients experienced local recurrence during their follow up, despite the lack of biopsy site resection. CT scans of the involved extremities were negative for any suspicious lesions in all patients up until the most recent follow-up.
Our study and review of the literature suggest that the incidence of tumor seeding the CNB tract in bone sarcoma patients is apparently low, and possibly negligible. CNB should be performed through the most direct approach to the tumor, and LSS can be performed safely through the standard approaches without excision of the biopsy tract.
我们评估了在进行肢体挽救手术（LSS）的骨肉瘤患者中，无论计划的手术切口部位如何，在进行诊断性粗针穿刺活检（CNB）后，沿粗针穿刺活检通道的局部复发率（LRR），且手术未涉及任何活检通道切除。
回顾性分析10例经计算机断层扫描引导下粗针穿刺活检诊断为骨肉瘤的儿科患者，评估从诊断之日至最近一次随访的病历、病理标本和放射影像。
尽管未进行活检部位切除，但所有患者在随访期间均未出现局部复发。直至最近一次随访，所有患者受累肢体的CT扫描均未发现任何可疑病变。
我们的研究及对文献的回顾表明，骨肉瘤患者中肿瘤沿粗针穿刺活检通道播散的发生率显然较低，甚至可能可忽略不计。应通过最直接的途径对肿瘤进行粗针穿刺活检，并且可以通过标准方法安全地进行肢体挽救手术，而无需切除活检通道。
