Transmucosal Core Needle Biopsy: A Novel Diagnostic Approach to Oral and Oropharyngeal Lesions

Abstract

Oral and oropharyngeal tumors have often been characterized by a deep submucosal growth pattern under an intact mucous membrane. This will be particularly true for lesions of the tongue and could be associated with relevant difficulties regarding diagnosis and treatment planning. We hypothesized that the transoral transmucosal application of a core needle biopsy (CNB) for lesions of the tongue, the base of the tongue, and the floor of the mouth could be of considerable clinical usefulness for many patients. It has only previously been described in single cases and has not yet been separately discussed. We report on the novel transoral use of CNB during rigid endoscopy with the patient under general anesthesia, with an emphasis on lesions of the tongue. A series of cases and illustrative patients are presented. Transmucosal CNB was accurate and of considerable clinical usefulness in all cases. The relevant advantages of this technique compared with conventional biopsy using biopsy forceps and transmucosal fine needle aspiration are presented. The transoral transmucosal approach to the submucosal space of the oral cavity and the oropharynx has further extended the field of application of CNB. In selected patients, this CNB approach offers essential diagnostic benefits, in particular, for tumors of the tongue.