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Background Accurate diagnosis of musculoskeletal tumors is essential for guiding appropriate treatment strategies. Percutaneous core needle biopsy (PCNB) is increasingly recognized as a valuable method for obtaining tissue samples for histopathological examination. This study aims to evaluate the diagnostic accuracy and clinical utility of PCNB in diagnosing musculoskeletal tumors. Methodology A total of 152 cases suspected of musculoskeletal tumors underwent PCNB at our tertiary care center between 2020 and 2023. Pre-biopsy evaluation included comprehensive clinical assessment and imaging studies. Core biopsies were performed under image guidance, with specimens sent for histopathological examination and culture sensitivity analysis. Diagnostic yield, accuracy, and performance metrics of PCNB were assessed. Results PCNB demonstrated a diagnostic yield of 93.4%. However, in cases where initial biopsies were inconclusive, repeat core biopsy or open biopsy provided the necessary diagnostic clarity. PCNB demonstrated a remarkable diagnostic accuracy of 97.9%, with a specificity and positive predictive value of 100%. There were no post-biopsy complications and no instances of local recurrence from the biopsy tract. Conclusions PCNB can be a reliable method for diagnosing musculoskeletal tumors, offering high diagnostic accuracy and minimal complications. The utilization of image guidance enhances precision and reduces the risk of complications. PCNB proves effective in diagnosing both primary tumors and bone infections, facilitating timely and appropriate treatment strategies in orthopedic oncology.
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BACKGROUND: With tremendous improvement in the survival of patients with malignant bone tumors, there is a greater emphasis on the functional outcome and durability of reconstruction following tumor resection. Tumor resection and extracorporeal irradiation (ECI) followed by reimplantation of the irradiated bone in malignant bone tumors is drawing popularity across various centers. In this study, we aim to put forward our experience with ECI, the outcomes achieved, and the complications faced by us. METHODS: This is a prospective study conducted in patients with malignant and locally aggressive bone tumors who underwent ECI at our center. A total number of 20 patients were selected for the study and followed up for a mean duration of 32.5 months (maximum duration: 58 months, minimum duration: eight months). Orthopedic outcome was measured using the Enneking score. We assessed for local recurrence, functional outcome, union, and complications during the follow-up. RESULTS: During the course of follow up, local recurrence was seen in two patients. The mean MSTS score of the remaining patients was found to be 23.6. Complications seen included limb length discrepancy, surgical site infection, and graft lysis. CONCLUSION: Tumor resection and ECI is an effective procedure for biological reconstruction which gives satisfactory functional outcomes. In spite of certain complications, patients expressed satisfaction with the overall outcome of the procedure.
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Introduction Campanacci Grade III Giant Cell tumors of the distal radius are difficult to manage as they are associated with a high recurrence rate. Wide excision of the distal radius and reconstruction with an ipsilateral proximal fibula or ulnar translocation reduces the recurrence rate significantly and gives acceptable function to the hand and wrist. Methods and materials This was a retrospective study of eight patients with Campanacci grade III giant cell tumors of distal radius treated with wide excision of distal radius followed by reconstruction at our institute. Four cases were operated on with ulnar translocation and four cases were operated on with ipsilateral proximal fibula grafting after wide excision of the distal radius. Patients were studied for the Musculoskeletal Tumor Society (MSTS) score and visual analogue scale (VAS) score for pain at one year, recurrence, and complications. Results The mean MSTS score of the total series was 24.75 ± 1.6. The mean VAS score for the total series was 1.62 ± 0.4. Of the eight cases, two cases had a recurrence, one patient had persistent wrist paint, and two patients had wrist subluxation. Conclusion Wide excision of the distal radius followed by reconstruction with a proximal fibula or ulnar translocation is a good option to avoid repeated surgeries in patients with Campanacci grade III giant cell tumors of the distal radius and achieve acceptable functional results for the wrist and hand.