Bone Abstracts

Introduction: Biopsy is a milestone in the diagnosis and treatment of skeletal lesions. Closed core-needle biopsy under computed tomography (CT) guidance is the gold standard. Open biopsy on the other hand may lead to more secure diagnosis.

Objectives: Aim of this retrospective case-series study was the review of all biopsies (closed and open) performed at our department during the last eleven years in children suffering from bone tumours and the evaluation of the diagnostic accuracy of the closed procedure.

Methods: We retrospectively reviewed the case notes of all children with bone lesions who were hospitalized at our department and underwent biopsies (closed or open). The necessity for additional open biopsy, the validation of the closed biopsy’s result with that of the definite pathology report following the excision of a lesion (when excision was performed) and the complication and morbidity rates accompanying closed and open biopsies were registered and analyzed.

Results: Between December 2003 and December 2014, a total of 112 biopsies were performed on 104 children (54 girls and 50 boys) suffering from 24 benign and 80 malignant skeletal lesions. A closed biopsy under CT-scan image guidance was initially performed under anesthesia in all cases. In 13 cases (7.7%) an open biopsy was additionally required. In 87 patients, the lesion was excised. The final pathology report of the excised specimen was in accordance with the initial report which was based on the biopsy tissue in 83 cases; in the remaining 4 cases there was a discrepancy between the two reports. In 3 out of these cases a closed biopsy had been performed. No complications developed following closed biopsies. Two patients had mild postoperative hematomas after open biopsies. An extraosseous migration of a primary aneurysmal bone cyst following closed CT-guided biopsy also developed, which required surgical intervention.

Conclusion: Closed image-guided core needle biopsy seems to be the gold standard method to accurately and efficiently obtain tissue for pathologic examination for benign and malignant skeletal lesions. When performed by experienced radiologists, this method is accompanied by very high success rates, less morbidity than the open and very high rates of diagnostic accuracy.

Disclosure: The authors declared no competing interests.