RADIOLOGICALLY-GUIDED CUTTING NEEDLE-BIOPSY FOR SUSPECTED MALIGNANCY IN CHILDHOOD

Twenty-seven cutting needle biopsies were performed on 25 children wit h suspected malignancy using computed tomographic (CT, 22) or ultrasou nd (US, 5) guidance. Anatomical sites were: retroperitoneum 6, liver 4 , kidney 4, abdomen/pelvis 4, thorax 4, bowel 2, neck 1. Sixteen patie nts (64%) underwent subsequent open biopsy (5), marrow biopsy (2) or r esection (9). There was complete concordance between the histological findings from the open or marrow biopsy and the previous needle biopsy in 12 of these 16 patients; in two patients the needle biopsy was mis leading, causing inappropriate initial treatment in one. In two other patients needle biopsy was correct but lacked specific diagnostic feat ures. Needle biopsies were performed under general, local or Ketamine anaesthesia. There were no apparent complications related to these pro cedures. We believe that radiologically-guided cutting needle biopsy s hould replace open biopsy in most children with solid malignant lesion s. It can easily be performed during a single anaesthetic episode whic h allows radiological evaluation, biopsy, bone marrow and cerebrospina l fluid sampling. However, the potential for sampling error and histol ogical variation within these tumours needs to be borne in mind.