Clin Orthop Relat Res 2018 03;476(3):568-577
V. Hegde, Z. D. C. Burke, H. Y. Park, S. D. Zoller, D. Johansen, B. V. Kelley, N. M. Bernthal, Department of Orthopaedic Surgery, University of California-Los Angeles, Santa Monica, CA, USA B. D Levine, K. Motamedi, L. L. Seeger, Department of Radiological Sciences, University of California-Los Angeles, Los Angeles, CA, USA N. C. Federman, Department of Pediatrics, University of California-Los Angeles, Los Angeles, CA, USA S. D. Nelson, Department of Pathology, University of California-Los Angeles, Santa Monica, CA, USA.
Background: Although there is widespread acceptance of core needle biopsy (CNB) for diagnosing solid tumors, there is reluctance by some clinicians to use CNB for aneurysmal bone cysts (ABCs) as a result of concerns of safety (bleeding, nerve injury, fracture, readmission, or infection) and reliability, particularly to rule out malignant diagnoses like telangiectatic osteosarcoma. This is especially true when CNB tissue is sent from an outside hospital, where the technique used to obtain the tissue may be spurious.
Questions/purposes: (1) Is CNB effective (provided adequate information to indicate appropriate surgical treatment without further open biopsy) as an initial diagnostic test for ABC? (2) Is CNB accurate (pathology consistent with the subsequent definitive surgical pathologic diagnosis) in differentiating between benign lesions such as primary or secondary ABCs and malignant radiolucent lesions such as telangiectatic osteosarcoma? (3) What are the complications of CNB? (4) Is there any difference in the effectiveness or accuracy of CNB performed at outside institutions when compared with a referral center?
Methods: A retrospective study of our musculoskeletal tumor board pathology database (1990-2016) was performed using search criteria "aneurysmal bone cyst" or "telangiectatic osteosarcoma. Read More