Excisional biopsy for bone tumours.

Abstract

Compartmental muscular resections without open biopsy is a common procedure for soft tissue tumours suspected of malignancy. In bone tumours, where the diagnosis is supposed to be sarcoma, an excisional biopsy is seldom possible without severe recontructive problems and it may be unnecessarily mutilating should the tumour be benign. For the fibula, the clavicula, metatarsal and metacarpal bones, the distal third of ulna and the proximal third of radius, however, excisional biopsy as the primary procedure should be taken into account. The resulting loss of function is minor and can well be accepted even if the tumour turns out to be benign. On the other hand, if it is malignant as supposed, the radical excisional biopsy saves the patient from amputation. When incisional biopsy is used instead of excisional biopsy the definite surgery has to be made much wider and will often be mutilating. A case of chondrosarcoma illustrates the advantage and the disadvantage of this principle as well as an unusual reconstruction.