[Significance of sonographically guided percutaneous needle biopsy in the diagnostics of soft tissue tumors]. / Stellenwert der sonographisch kontrollierten perkutanen Stanzbiopsie in der Diagnostik von Weichgewebstumoren.

BACKGROUND: The role of percutaneous needle biopsy in the diagnostics of soft tissue tumors is controversially discussed. The specificity of this method has been examined in this study based on the collective of patients treated in our university hospital. Secondly, the influence of the specialization of the treating surgeon has been evaluated. PATIENTS AND METHODS: This study included 96 patients who underwent percutaneous needle biopsy and, if necessary, surgical resection. The specificity, logistic requirements and possible complications of percutaneous biopsy were evaluated. Special attention was paid to the influence of specialization of the treating surgical team on the specificity of the method. RESULTS: The results of the biopsy were able to define the entity of the lesion correctly in 69.7 %, the dignity in 75.0 % and the grading in 72.0 % of the cases. In the group treated by a specialized team, the specificity of the method was 84.6 % concerning the entity of the lesion, 84.6 % concerning the dignity and 80 % concerning the grading. With regard to the entity the specificity was significantly increased (p < 0.05). CONCLUSION: The findings show that percutaneous needle biopsy represents a logistically simple and efficient diagnostic method for soft tissue tumors which is rarely associated with complications. Subsequent treatment should be performed in a specialized centre.

[Diagnosis and therapy of soft tissue sarcomas of the extremities]. / Diagnostik und Therapie von Weichteilsarkomen der Extremitäten.

The diagnosis of unclear soft tissue tumors represents a common problem in everyday clinical practice. Magnetic resonance imaging often reveals some first information about soft tissue tumors; however, clarification of the dignity can only be achieved by histopathological examination. Most of the lesions are benign but should be treated as a malignant tumor until this can be excluded as unnecessary surgery or biopsies can complicate treatment and worsen the prognosis. These aspects in particular are summarized and discussed in this article.

[Diagnostics and treatment of primary bone tumors]. / Diagnostik und Therapie primärer Knochentumoren.

Primary bone tumors can be either benign or malignant. Metastization is a characteristic feature of malignant bone tumors. Malignant tumors are characterized by a local aggressive and destructive behavior. The behavior of a tumor is dependent on its entity, the differentiation grade and localization and these factors are of decisive importance for the correct therapy. Even benign tumors can behave very aggressively. Different stages are defined. Patient history and conventional radiographs are the most powerful primary diagnostic tools. Many tumors show typical characteristics and if a malignant lesion is suspected a biopsy should be carried out. Several quality standards have to be respected when making the biopsy. The approach to malignant tumors is always interdisciplinary. Several biological as well as alloplastic reconstruction techniques exist. The treatment of primary malignant bone tumors requires a lot of experience and should only be done in specialized centers.

[Injury to the subclavian and vertebral arteries in childhood following blunt force trauma]. / Verletzung der Aa. subclavia und vertebralis im Kindesalter nach stumpfem Trauma.

Injuries of great vessels, such as the subclavian or vertebral arteries in childhood are rare. More frequent and therefore better described are dissections of the vertebral artery, which frequently occur following low energy trauma. The combination of dissection of the vertebral and subclavian arteries described in this case study led to sensory affections of the left arm. Therapeutic anticoagulation is the therapy of choice to avoid possible ischemic insults. The therapeutic approach of injuries to the subclavian artery remains unclear and is in the focus of discussions.