Evaluation of the use of Tru-Cut Needle Biopsy in the Diagnosis of Chest Wall Tumors

Abstract

Introduction: Chest wall tumors can be either primary, metastatic or radiation induced. Moreover, it can be due to involvement by lung or breast cancer. Although clinical and radiological assessments are important in evaluation of patients with chest wall tumors; the histo-pathological diagnosis remains the most important factor in determining the appropriate management. One of the methods to get tissue biopsy is tru-cut needle biopsy. Aim: This study aimed to determine the efficacy and complications of the use of tru-cut needle biopsy in diagnosis of chest wall tumors. Patients and methods: This is a retrospective study in which the files of patients who underwent tru-cut needle biopsy at cardiothoracic surgery department of Alexandria University were reviewed. Results: Twenty patients (13 males and 7 females) underwent tru-cut needle biopsy for chest wall tumors during the period between January 2003 and December 2008. Age ranged between 17 to 75 years (52.4 ± 13.7 years old). Ninety-five percent of patients were presented with chest wall swelling either alone or with pain. All patients except one had tru-cut needle biopsy without radiological assist. Tru-cut needle biopsy was performed with the aid of fluoroscopy in one patient. Pre-operative tissue diagnosis could be established with accuracy in 90% of patients. In 90% of patients, tru-cut needle biopsy was able to determine if the lesion is benign or malignant while in two patients it was inconclusive. No complications were encountered during or following the procedure. Moreover, no recurrence at the site of biopsy was detected during 3 years follow-up. Conclusion: Tru-cut needle biopsy; with or without radiological assist; is of utmost help in accurate pre-operative histo-pathological diagnosis with minimal complications. Accuracy in determination of diagnosis depends on the skills of the personnel who perform the biopsy and the pathologist. Recurrence at site of the biopsy is rare.