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 Percutaneous technique 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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