Biopsy principles of musculoskeletal tumours - when, where, who and how?

Histological assessment with a well representative adequate sample would be the key step in diagnosis of musculoskeletal tumors, but poorly performed biopsy remains a common finding in patients with musculoskeletal tumors who are referred to orthopaedic units. Success of a biopsy in musculoskeletal tumour pathology is based on the answers to several vital questions. These questions are when to biopsy? Who should perform the biopsy? where to take the biopsy? And How to biopsy? Errors in answers to these questions will lead to errors in biopsy, misleading the diagnosis and adversely affecting the survival of the patient. Subsequently patients may require an amputation to achieve an adequate surgical resection instead of a limb salvage procedure. In order to minimize the errors related to biopsy, it is mandatory to follow a set of guidelines during the biopsy procedure. This article will discuss the proper biopsy procedure by seeking answers to the above questions.

The Sri Lanka Journal of Surgery 2015; 33(2): 20-24