RESUMO
We report on a 58-year-old woman who underwent total sacrectomy and spinopelvic reconstruction for a low-grade malignant peripheral nerve sheath tumour involving the sacrum. One week later, she developed deep wound infection, and the entire spinopelvic reconstruction was removed. At the 36-month followup, the patient had no pain and was able to walk with a walking frame. There was no sign of recurrence or metastasis.
Assuntos
Neoplasias de Bainha Neural/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Sacro/cirurgia , Neoplasias da Coluna Vertebral/cirurgia , Desbridamento , Remoção de Dispositivo , Feminino , Humanos , Úmero/transplante , Vértebras Lombares/cirurgia , Pessoa de Meia-Idade , Neoplasias de Bainha Neural/diagnóstico , Ossos Pélvicos/cirurgia , Procedimentos de Cirurgia Plástica/efeitos adversos , Neoplasias da Coluna Vertebral/diagnóstico , Infecção da Ferida Cirúrgica/etiologia , Transplante HomólogoRESUMO
PURPOSE. To compare computed tomography (CT)- guided core needle biopsy (CNB) with incisional biopsy in diagnosing musculoskeletal lesions. METHODS. 62 men and 50 women aged 12 to 83 (mean, 45) years who underwent a CT-guided CNB were compared with 31 men and 33 women aged 9 to 81 (mean, 53) years who underwent an incisional biopsy. All specimens had final pathology report to compare with. Comparisons were made in terms of (1) diagnostic rate, (2) accuracy in distinguishing benign from malignant lesions, (3) accuracy in distinguishing low- from high-grade sarcomas, (4) accuracy for histological diagnosis, and (5) complication and repeated biopsy rates. RESULTS. The diagnostic rate of CT-guided CNB and incisional biopsy was not significantly different (92.9% vs. 96.9%, p=0.33), nor were the accuracy in distinguishing benign from malignant lesions (100% vs. 98.4%, p=0.37), the accuracy in distinguishing low- from high-grade sarcomas (100% vs. 100%, p=1.00), the accuracy for specific diagnosis (75.9% vs. 85.2%, p=0.17), the repeated biopsy rate (6.3% vs. 4.7%, p=0.75), and the complication rate (0.9% vs. 4.7%, p=0.14). The accuracy for specific diagnosis was higher for bone than soft-tissue lesions for both CT-guided CNB (87.0% vs. 59.5%, p=0.002) and incisional biopsy (87.0% vs. 77.3%, p=0.43). The accuracy of CT-guided CNB for specific diagnosis of benign soft-tissue tumours as well as infection and inflammation was relatively low. CONCLUSION. CT-guided CNB is safe, easy to perform, efficient, and less invasive, and should be considered as a first-line biopsy for musculoskeletal lesions.
