Biopsy of Bone and Soft Tissue Tumors

Our center specializes in performing precise, well-planned biopsies that are critical for accurate diagnosis of bone and soft tissue tumors. The biopsy procedure is one of the most important steps in Orthopaedic Oncology, as it provides the tissue diagnosis that guides all subsequent treatment decisions. We follow strict oncological principles to ensure diagnostic accuracy while preserving future surgical options.

Percutaneous Image-Guided Biopsy Techniques

We provide expert minimally invasive biopsy procedures using advanced imaging guidance:

• CT-Guided Biopsy: Precision sampling of bone and deep soft tissue lesions using computed tomography for real-time needle guidance and accurate targeting.
• Ultrasound-Guided Biopsy: Ideal for superficial soft tissue masses, providing excellent visualization of needle placement and surrounding structures.
• Fluoroscopy-Guided Biopsy: Real-time X-ray guidance for bony lesions, particularly useful for vertebral body and pelvic lesions.
• MRI-Guided Biopsy: Advanced imaging guidance for lesions best visualized with magnetic resonance imaging, especially in complex anatomical locations.
• Core Needle Biopsy: Using specialized needles to obtain tissue cores that preserve architectural relationships for accurate histopathological diagnosis.

Open Surgical Biopsy Techniques

Our comprehensive approach to open biopsy includes techniques designed for diagnostic accuracy and oncological safety:

• Incisional Biopsy: Carefully planned surgical approach to obtain adequate tissue samples from large tumors while minimizing contamination.
• Excisional Biopsy: Complete removal of small tumors (typically less than 3-5cm) with a margin of normal tissue, both diagnostic and therapeutic.
• Frozen Section Analysis: Intraoperative histological examination to confirm adequate sampling and preliminary diagnosis, guiding immediate surgical decisions.
• Optimal Surgical Approach: Meticulous planning of biopsy incisions to allow for complete incorporation into future definitive resection incisions.
• Hemostasis and Wound Closure: Meticulous technique to prevent hematoma formation and tumor cell dissemination.

Specialized Biopsy Considerations

We employ specialized techniques for challenging anatomical locations and tumor types:

• Spinal Biopsies: Precise techniques for vertebral body and spinal lesions using CT guidance to avoid neural structures and critical vessels.
• Pelvic Biopsies: Special approaches for iliac wing, sacral, and acetabular lesions with careful planning to avoid contamination of future surgical planes.
• Joint and Epiphyseal Biopsies: Techniques designed to preserve joint function and growth plates in pediatric patients.
• Small Round Blue Cell Tumors: Special handling for tumors requiring fresh tissue for cytogenetics, molecular studies, and electron microscopy.
• Lymph Node Biopsy: Sentinel node biopsy and regional node sampling for tumors with known lymphatic spread patterns.

Our Comprehensive Approach

We employ a multidisciplinary team approach involving radiologists, pathologists, and orthopaedic oncologists to ensure diagnostic accuracy and optimal planning. Our services include:

• Pre-biopsy imaging and multidisciplinary consultation for optimal approach planning
• Collaboration with expert pathologists for accurate histopathological and molecular analysis
• Use of advanced imaging modalities (CT, MRI, ultrasound) for precise targeting
• Minimization of tumor seeding and contamination risks
• Coordination with surgical teams to align biopsy with future resection plans
• Patient education and counseling on biopsy procedures and implications

We recognize the critical role of biopsy in determining the correct diagnosis and treatment plan for bone and soft tissue tumors. Our team is dedicated to performing these procedures with the highest precision and care, ensuring accurate results while safeguarding future treatment options and patient outcomes.