Primary musculoskeletal neoplasms: Effectiveness of core-needle biopsy

PURPOSE: To analyze the effectiveness of core-needle biopsy for evaluation of possible primary musculoskeletal neoplasms, which often are evaluated wi th open biopsy. MATERIALS AND METHODS: Core-needle biopsy was performed at a tertiary care institution in 141 patients suspected of having a mesenchymal neoplasm. In 85 patients, the lesion was in soft tissue; in 56 patients, the lesion was in bone. Eighty-nine patients had a malignant lesion, and 52 had a benign l esion. Twenty-eight patients had undergone previous surgery. RESULTS: In 105 (74%) patients, core-needle biopsy results were concordant with results from specimens subsequently obtained at surgery with respect t o tumor histologic features and grade, or they provided sufficient diagnost ic information to obviate surgery. In 36 (26%) patients, inaccurate core-ne edle biopsy results were obtained: In nine, results were imprecise about ex act histologic features; in three, results were correct about histologic fe atures but incorrect about tumor grade. In 25 (18%) patients, open biopsy w as performed after core-needle biopsy. The accuracy and rate of performance of open biopsy for soft-tissue lesions were not significantly different fr om those for bone lesions. CONCLUSION: Percutaneous core-needle biopsy can be an effective alternative to open biopsy in the evaluation of possible mesenchymal neoplasms of eith er bone or soft tissue. Needle biopsy of such lesions, however, is best per formed as part of a multidisciplinary team approach to tumor management.