CT-Guided Trans-osseous Biopsy: Experience in 24 Patients.

PURPOSE: The objective of this study is to assess the effectiveness of computed tomography-guided trans-osseous biopsies in deep-seated lesions and report encountered complications. MATERIALS AND METHODS: A retrospective cohort study was performed which included twenty-four patients with pathologic medical history and lesions non-accessible by common approaches. Exclusion criteria include patients who could be biopsied without trans-osseous access, as for example procedures aided with hydro- or pneumo-dissection. The population studied included 13 females (54.2%) and the overall average age was 64.5 (IIQ 43-69). The procedures were carried out through the following bones: sternum (n = 6), vertebral (n = 5), iliac (n = 5), scapula (n = 3), rib (n = 2), sacral (n = 2), and pubis (n = 1). RESULTS: The efficiency for these procedures was 87.5%, while 8.33% of them were non-diagnostic and 4.17% were inconclusive due to vital risk during the procedure. CONCLUSION: Computed tomography-guided trans-osseous biopsy resulted in a safe and effective technique for those lesions blocked by vital structures or apparently directly inaccessible.

[Retroperitoneal lymphadenopathy trans-vertebral image-guided biopsy: a case report] / Biopsia de linfadenopatía retroperitoneal guiada por imágenes con abordaje trans-vertebral: reporte de un caso

Introduction: Transosseous biopsy allows sampling of lesions that are difficult to access with conventional techniques. Its use avoids surgeries. Objective: To present a clinical case in which retroperitoneal percutaneous biopsy with trans vertebral approach was used. A brief bibliographic revision of this technique will be made. Case: 60 year old woman with endometrial adenocarcinoma, with 7 months of clinical symptoms characterized by asthenia and non-specific lumbar pain. An intercaval aortic lymphadenopathy was found. Trans vertebral biopsy of the lesion was decided, its location precluded conventional approaches access. Conclusion: This technique must be considered when studying unreacheable lesions by other means and performed by trained professionals.

Introducción: La biopsia trans ósea permite el estudio de lesiones que presentan accesos convencionales bloqueados por otras estructuras, como órganos vitales. Su uso evita procedimientos de mayor complejidad. Objetivo: Reportar un caso clínico en el cual se utilizó la técnica de biopsia percutánea con abordaje trans vertebral para toma de muestra. En forma secundaria se hará una breve revisión de la bibliografía. Caso: Caso: Mujer de 60 años, con adenocarcinoma de endometrio con cuadro clínico de 7 meses caracterizado por astenia y dolor lumbar. Presentaba una linfadenopatía intercavo-aórtica. Se decidió biopsiar de forma trans vertebral debido a que su ubicación limitaba otros abordajes. Conclusión: Este abordaje debe ser considerado para acceder a lesiones inalcanzables por otras vías y ser empleado por profesionales entrenados.  Palabras claves: biopsia guiada por imágenes; metástasis linfática; neoplasias de endometrio.