Evaluation of a Soft Tissue Mass in the Extremity or Trunk

2018 ◽  
Author(s):  
Daniel C Thomas ◽  
Dale Han
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Physical Examination ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Malignant Tumors ◽  
Soft Tissue Mass ◽  
Tissue Mass ◽  
Core Needle ◽  
Needle Tract

Soft tissue sarcoma (STS) represents a diverse group of malignant tumors derived from mesenchymal elements. Evaluation of a soft tissue mass of the trunk or extremity starts with a detailed history and physical examination, which will help guide further diagnostic evaluation.  Imaging should then be obtained for an STS, with MRI being the preferred modality for the trunk or extremities. Imaging can assist with diagnosis and delineate the extent of the primary lesion, including the relationship to contiguous structures, for treatment planning and assessing resectability. Pathology diagnosis is most commonly performed via examination of a specimen obtained through image-guided percutaneous core-needle biopsy. This requires multidisciplinary planning between Surgery and Radiology to place the needle within the anticipated definitive surgical incision to allow for en bloc resection of the needle tract. Once the diagnosis of an STS is made, appropriate staging studies should be performed based on the history and physical examination and tumor histology, grade, and size. Clinical and pathology data are used to stage STS patients using the American Joint Committee on Cancer staging system, which incorporates the STS site, size and grade of the primary tumor, and absence or presence of nodal and distant metastatic disease. This review contains 6 figures, 6 tables and 50 references Key words: core-needle biopsy, extremity, histology, imaging, risk factors, soft tissue mass, soft tissue sarcoma, staging evaluation, trunk, tumor grade

Evaluation of a Soft Tissue Mass in the Extremity or Trunk

2018 ◽  
Author(s):  
Daniel C Thomas ◽  
Dale Han
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Physical Examination ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Malignant Tumors ◽  
Soft Tissue Mass ◽  
Tissue Mass ◽  
Core Needle ◽  
Needle Tract

Soft tissue sarcoma (STS) represents a diverse group of malignant tumors derived from mesenchymal elements. Evaluation of a soft tissue mass of the trunk or extremity starts with a detailed history and physical examination, which will help guide further diagnostic evaluation.  Imaging should then be obtained for an STS, with MRI being the preferred modality for the trunk or extremities. Imaging can assist with diagnosis and delineate the extent of the primary lesion, including the relationship to contiguous structures, for treatment planning and assessing resectability. Pathology diagnosis is most commonly performed via examination of a specimen obtained through image-guided percutaneous core-needle biopsy. This requires multidisciplinary planning between Surgery and Radiology to place the needle within the anticipated definitive surgical incision to allow for en bloc resection of the needle tract. Once the diagnosis of an STS is made, appropriate staging studies should be performed based on the history and physical examination and tumor histology, grade, and size. Clinical and pathology data are used to stage STS patients using the American Joint Committee on Cancer staging system, which incorporates the STS site, size and grade of the primary tumor, and absence or presence of nodal and distant metastatic disease. This review contains 6 figures, 6 tables and 50 references Key words: core-needle biopsy, extremity, histology, imaging, risk factors, soft tissue mass, soft tissue sarcoma, staging evaluation, trunk, tumor grade

scholarly journals Diagnostic accuracy of ultrasound-guided core needle biopsy versus incisional biopsy in soft tissue sarcoma: an institutional experience

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Miroslava Cernakova ◽  
Gerhard M. Hobusch ◽  
Gabriele Amann ◽  
Philipp T. Funovics ◽  
Reinhard Windhager ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Correct Identification ◽  
Incisional Biopsy ◽  
Ultrasound Guided ◽  
Histologic Subtype ◽  
Core Needle ◽  
Biopsy Technique

AbstractCore needle biopsy (CNB) is gaining in importance due to its advantages in the matter of patient morbidity, time and cost. Nevertheless, controversies still exist regarding the biopsy technique of choice for the accurate diagnosis of soft tissue sarcoma (STS). This retrospective cohort study compared the diagnostic performance between ultrasound-guided CNB and incisional biopsy (IB), both performed by orthopedic surgeons. The aims of the study were to answer the following questions: (1) Is ultrasound-guided CNB a highly reliable modality for diagnosing STSs? (2) Is CNB equally useful to IB for identifying histologic subtype? (3) Had patients who underwent CNB a reduced risk of complications? One-hundred and fifty-three patients who underwent resection of soft tissue sarcoma were classified into two groups according to biopsy technique prior to surgery; CNB group (n = 95) and IB group (n = 58). The final surgical specimens were in 40 patients liposarcoma (myxoid, pleomorphic and dedifferentiated), 39 undifferentiated pleomorphic sarcoma (UPS), 33 myxofibrosarcoma, 10 synovial sarcoma, 10 leiomyosarcoma and in the remaining 21 patients different soft tissue sarcoma entities. Sarcoma location of 71 patients was in the thigh, 19 in the lower leg, 22 in the upper arm and shoulder area; 10 in the knee and gluteal region, 9 in the thoracic region, the residual 12 in other body areas. Malignancy was correctly diagnosed in 87% (83 of 95) for the CNB group and 93% (54/58) for the IB group. Correct identification rate of histologic subtype was 80% (76 of 95) in the CNB group and 83% (48 of 58) in the IB group. There were no significant differences in the correct diagnosis rates of malignancy and subtype between the two techniques. No complications were seen in the CNB group, whereas 2 patients in whom IB was performed developed pulmonary embolism and 1 patient surgical site infection. Ultrasound-guided CNB is highly accurate and not inferior to IB in diagnosing the dignity of lesions and histologic subtype in patients with suspected STSs.

Core needle biopsy for diagnosis of extremity soft tissue sarcoma

1997 ◽  
Vol 4 (5) ◽  
pp. 425-431 ◽  
Author(s):  
Martin J. Heslin ◽  
Jonathan J. Lewis ◽  
James M. Woodruff ◽  
Murray F. Brennan
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Core Needle ◽  
Extremity Soft Tissue Sarcoma

scholarly journals Adult Soft Tissue Sarcoma Local Recurrence After Adjuvant Treatment Without Resection of Core Needle Biopsy Tract

2013 ◽  
Vol 471 (3) ◽  
pp. 891-898 ◽  
Author(s):  
Odion Binitie ◽  
Shawn Tejiram ◽  
Sheila Conway ◽  
David Cheong ◽  
Thomas H. Temple ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Local Recurrence ◽  
Soft Tissue Sarcoma ◽  
Adjuvant Treatment ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Core Needle

scholarly journals Diagnostic Accuracy of Ultrasound-Guided Core Needle Biopsy Versus Incisional Biopsy in Soft Tissue Sarcoma: An Institutional Experience.

2021 ◽  
Author(s):  
Miroslava Cernakova ◽  
Gerhard Martin Hobusch ◽  
Gabriele Amann ◽  
Philipp Theodor Funovics ◽  
Reinhard Windhager ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Correct Identification ◽  
Incisional Biopsy ◽  
Ultrasound Guided ◽  
Histologic Subtype ◽  
Core Needle ◽  
Biopsy Technique

Abstract Background Core needle biopsy (CNB) is gaining in importance due to its advantages in the matter of patient morbidity, time and cost. Nevertheless, controversies still exist regarding the biopsy technique of choice for the accurate diagnosis of soft tissue sarcoma (STS). This study compared the diagnostic performance between ultrasound-guided CNB and incisional biopsy (IB), both performed by orthopedic surgeons. Questions/purposesThe aims of the study were to answer the following questions: (1) Is ultrasound-guided CNB a highly reliable modality for diagnosing STSs? (2) Is CNB equally useful to IB for identifying histologic subtype? (3) Had patients who underwent CNB a reduced risk of complications? MethodsOne-hundred and seventy-five patients who underwent resection of soft tissue sarcoma were classified into two groups according to biopsy technique prior to surgery; CNB group (n=109) and IB group (n=66). The final surgical specimens were in 62 patients liposarcoma, 39 undifferentiated pleomorphic sarcoma (UPS), 33 myxofibrosarcoma, 10 synovial sarcoma, 10 leiomyosarcoma and in the remaining 21 patients different soft tissue sarcoma entities. Sarcoma location of 90 patients was in the thigh, 21 in the lower leg, 22 in the upper arm and shoulder area; 10 in each the knee, gluteal and thoracic region, the residual 12 in other body areas. Results Malignancy was correctly diagnosed in 86% (94 of 109) for the CNB group and 91% (60/66) for the IB group. Correct identification rate of histologic subtype was 80% (87 of 109) in the CNB group and 82% (54 of 66) in the IB group. There were no significant differences in the correct diagnosis rates of malignancy and subtype between the two techniques. No complications were seen in the CNB group, whereas 2 patients in whom IB was performed developed pulmonary embolism and 1 patient surgical site infection. Conclusions Ultrasound-guided CNB is highly accurate and not inferior to IB in diagnosing the dignity of lesions and histologic subtype in patients with suspected STSs.

Percutaneous Imaging-Guided versus Open Musculoskeletal Biopsy: Concepts and Controversies

2020 ◽  
Vol 24 (06) ◽  
pp. 667-675
Author(s):  
Violeta Vasilevska Nikodinovska ◽  
Slavcho Ivanoski ◽  
Milan Samardziski ◽  
Vesna Janevska
Keyword(s):  
Soft Tissue ◽  
Complication Rate ◽  
Core Needle Biopsy ◽  
Multidisciplinary Team ◽  
Gold Standard ◽  
Needle Biopsy ◽  
Soft Tissue Tumors ◽  
Open Biopsy ◽  
Core Needle ◽  
Similar Accuracy

AbstractBone and soft tissue tumors are a largely heterogeneous group of tumors. Biopsy of musculoskeletal (MSK) tumors is sometimes a challenging procedure. Although the open biopsy is still considered the gold standard for the biopsy of MSK lesions, core needle biopsy can replace it in most cases, with similar accuracy and a low complication rate. The biopsy should be performed in a tertiary sarcoma center where the multidisciplinary team consists of at minimum a tumor surgeon, an MSK pathologist, and an MSK radiologist who can assess all steps of the procedure. Several factors can influence the success of the biopsy including the lesion characteristics, the equipment, and the method used for the procedure. This review highlights some of the important aspects regarding the biopsy of the MSK tumors, with special attention to imaging a guided core needle biopsy and highlighting some of the recent advancements and controversies in the field.

Image-guided percutaneous core needle biopsy of soft-tissue masses in the pediatric population

2016 ◽  
Vol 46 (8) ◽  
pp. 1173-1178 ◽  
Author(s):  
Terrence Metz ◽  
Amer Heider ◽  
Ranjith Vellody ◽  
Marcus D. Jarboe ◽  
Joseph J. Gemmete ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Pediatric Population ◽  
Core Needle ◽  
Image Guided ◽  
Percutaneous Core Needle Biopsy ◽  
Soft Tissue Masses
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