Ultrasound‑guided tru‑cut biopsy of pelvic tumors: First reported case series in the Philippines / Philippine Journal of Obstetrics and Gynecology

@#This paper documents the first reported cases of patients in the country who underwent transvaginal ultrasound‑guided Tru‑cut biopsy of pelvic tumors in a tertiary level health institution in 2019. Different indications for Tru‑cut biopsy were demonstrated highlighting its clinical utility in the diagnosis and management of malignant pelvic tumors. All patients warranted histologic diagnosis for further planning of the most appropriate management. Adequate tissue samples were obtained from all three patients with no procedure‑related complications.

Accuracy of the standard systematic 12-core transrectal ultrasound-guided biopsy on a prostate phantom model

OBJECTIVE@#The detection rate of the current standard systematic 12 core transrectal ultrasound (TRUS)guided prostate biopsy remains low despite numerous modifications of the technique. This non-randomized experimental study evaluated the accuracy of standard TRUS-guided systematic prostatebiopsy as performed by selected urologists in obtaining samples representative of the peripheral zoneof the prostate, by analyzing virtual biopsies performed on a prostate phantom model.@*MATERIALS AND METHODS@#Thirty (30) urologists (26 consultants and 4 senior residents) were invited toperform two consecutive simulation TRUS guided 12-core biopsies on a phantom prostate model.The task was to hit twelve equal sized spherical targets which would correspond to the lateral andextreme lateral areas of the base, mid gland and apex of the peripheral zone of the phantom prostate,which would represent the usual biopsy technique. Degree of agreement (kappa) was computed.Eight (8) operators had below satisfactory kappa values and were excluded from the succeedinganalysis. Accuracy was calculated by dividing the number of accurately hit targets by the number ofvirtual cores (12). Data were encoded in MS Excel and Stata MP v.14 was used for data analysis.@*RESULTS@#Overall, the mean accuracy was 63.17% and median accuracy was 60% (95% CI: 49.2-65.15)for the 22 operators included in the study. The lateral regions, particularly the midgland (95.8%-100% accuracy) were the most frequently biopsied areas and were often resampled. The targets at theprostatic base were missed by most operators (36.05% accuracy).@*CONCLUSION@#Systematic TRUS guided prostate biopsy, in the manner that it is performed, has itsinherent flaws, compounded by limitations in imaging capability and intra-operator variabilityresulting in low accuracy rates. A shift to newer prostate biopsy technique and methodologies withsignificantly higher accuracy rates is recommended.

Procore and Flexible 19 Gauge Needle Can Replace Trucut Biopsy Needle?

Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is routinely performed for establishing tissue diagnosis in patients with gastrointestinal tumors. The concept of delivering chemotherapy based on molecular markers and the ability to establish a reliable diagnosis in lieu of an onsite cytopathologist has fuelled the recent trend in procuring core tissue by means of EUS-guided fine needle biopsy. To overcome the technical limitations induced by the rigidity of the Trucut biopsy needle, a new ProCore needle with reverse bevel technology has been developed. Recent data suggests that the newly developed flexible 19 gauge needle can also procure core tissue and has easy maneuverability when navigating the transduodenal route. Irrespective of the needles being used, the best clinical outcomes can be attained only by practicing evidence-based techniques, procuring adequate quantity of sample for ancillary studies, and processing the specimens appropriately.

Liposarcoma mixoide retroperitoneal, reporte de un caso

Los tumores retroperitoneales son de gran variedad histológica y dependen del órgano o tejido del cual se derivan. Generalmente son malignos y de origen mesenquimatoso. Representan el 0,3 y 0,8 % de todas las neoplasias. El liposarcoma es el más frecuente y está entre los sarcomas más comunes en todas las localizaciones en un 25 a 35%. Se presenta caso de femenino de 31 años de edad quien acudió por aumento de volumen abdominal, con dolor en cuadrante superior derecho irradiado a espalda. En estudios paraclínicos reportan tumor retroperitoneal gigante que desplazaba órganos retroperitoneales y abdominales. Se tomó muestra por tru-cut ecoguiada que concluyó liposarcoma mixoide retroperitoneal. Se realizó extirpación quirúrgica con tratamiento adyuvante. Sin embargo a los 2 y 4 años posterior recidivó la tumoración, que ameritaron reintervención. Curso clínico desfavorable y en su seguimiento presentó derrame pleural, ascitis, trombosis venosa profunda y sepsis de punto de partida abdominal que conllevaron a su fallecimiento. En vista de lo poco frecuente de esta entidad clínica y la agresividad que representa es importante su conocimiento para el manejo multidisciplinario.

Retroperitoneal tumors are of a great histologic variety, depending mostly on the organ of origin. They are generally malignant and of mesenquimal origin. They represent 0.3 to 0.8% of all neoplasias. Liposarcoma is the most frecuently found among all sarcomas in all locations in 25 to 35%. We present the case of a 31 year old female patient who consulted presenting an increase of her abdominal volume, with right upper quadrant abdominal pain in radiated to her back. Complementary studies reported a giant retroperitoneal tumor displacing other retroperitoneales and abdominal organs. An ultrasoun guided tru-cut sample was taken that reported myxoid liposarcoma. Surgical removal of the tumor and adjuvant treatment was given to the patient. Nevertheless 2 and 4 years later the tumor reappeared requiring further surgical removal. Unfavorable clinical outcome followed , presenting pleural effusionl, ascitic fluid, deep venous thrombosis and sepsis leading to her death. This unfrequent and aggressive entity must be acknoledged and multidisciplinary handled.

Transrectal Ultrasound-guided Biopsy Diagnosis of 63 Cases of Prostate Cancer / 医学研究杂志

Objective To study the transrectal ultrasound-guided biopsy diagnosis of prostate cancer.Methods 63 cases of prostate puncture,aged 41-85 years,with an average age of 65 included.They were all got transrectal ultrasound-guided prostate puncture by use of the Denmark B-rectal ultrasound probe,with frequency of 5～10 MHz,selection of 18 G Trucnt biopsy needle biopsy and biopsy gun.After the perineum skin puncture of lesions,the method was 6 position puncture in convention.Antibiotic treatment was given in convention after surgery.Results There were 27 cases of prostate cancer,24 cases of benign prostatic hyperplasia nodules,9 cases of prostatitis,2 cases of prostate tuberculosis,and one case of prostatic hyperplasia atypical cells.Conclusion Transrectal ultrasound-guided is safe,small trauma,reliable,and less postoperative complications while in biopsy diagnosising of prostate cancer.It is worthy of promotion in clinic.