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Erschienen in: Skeletal Radiology 9/2015

01.09.2015 | Scientific Article

Accuracy and complications of CT-guided core needle biopsy of peripheral nerve sheath tumours

verfasst von: Marcus Pianta, Eric Chock, Stephen Schlicht, David McCombe

Erschienen in: Skeletal Radiology | Ausgabe 9/2015

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Abstract

Objective

This single-centre study retrospectively reviews the complications in patients that have occurred following peripheral nerve sheath tumour biopsy, and assesses whether there is an association with biopsy technique or underlying lesion characteristics.

Materials and methods

41 consecutive core needle biopsies of proven peripheral nerve sheath tumours over a 2-year period in a tertiary teaching hospital were reviewed. Patient demographics and symptoms, tumour characteristics and radiological appearances were recorded. Biopsy and surgical histology were correlated, and post-biopsy and surgical complications analyzed.

Results

41 biopsies were performed in 38 patients. 68 % schwannomas, 24 % neurofibromas and 7 % malignant peripheral nerve sheath tumours. Biopsy histology correlated with surgery in all cases. 71 % of lesions were surgically excised. 60 % of patients reported pain related to their lesion. Following the biopsy, 12 % reported increased pain, which resolved in all cases. Pain exacerbation was noted in tumours smaller in size, more superficial and in closer proximity of the biopsy needle tip to the traversing nerve. Number of biopsy needle passes was not associated with an increased incidence of procedure-related pain.

Conclusion

Core biopsy of a suspected peripheral nerve sheath tumour may be performed safely before excisional surgery to confirm lesion histology and assist prognosis. There is excellent correlation between core biopsy and excised surgical specimen histology. The most common complication of pain exacerbation is seen in a minority and is temporary, and more likely with smaller, more superficial lesions and a closer needle-tip to traversing nerve distance during biopsy.
Fußnoten
1
99% total due to rounding.
 
Literatur
1.
Zurück zum Zitat Rodriguez FJ, Folpe AL, Giannini C, Perry A. Pathology of peripheral nerve sheath tumors: diagnostic overview and update on selected diagnostic problems. Acta Neuropathol. 2012;123(3):295–319.PubMedCentralPubMedCrossRef Rodriguez FJ, Folpe AL, Giannini C, Perry A. Pathology of peripheral nerve sheath tumors: diagnostic overview and update on selected diagnostic problems. Acta Neuropathol. 2012;123(3):295–319.PubMedCentralPubMedCrossRef
2.
Zurück zum Zitat Kim DH, Murovic JA, Tiel RL, Moes G, Kline DG. A series of 397 peripheral neural sheath tumors: 30-year experience at Louisiana State University Health Sciences Center. J Neurosurg. 2005;102(2):246–55.PubMedCrossRef Kim DH, Murovic JA, Tiel RL, Moes G, Kline DG. A series of 397 peripheral neural sheath tumors: 30-year experience at Louisiana State University Health Sciences Center. J Neurosurg. 2005;102(2):246–55.PubMedCrossRef
3.
Zurück zum Zitat Levi AD, Ross AL, Cuartas E, Qadir R, Temple HT. The surgical management of symptomatic peripheral nerve sheath tumors. Neurosurgery. 2010;66(4):833–40.PubMedCrossRef Levi AD, Ross AL, Cuartas E, Qadir R, Temple HT. The surgical management of symptomatic peripheral nerve sheath tumors. Neurosurgery. 2010;66(4):833–40.PubMedCrossRef
4.
Zurück zum Zitat Hrehorovich PA, Franke HR, Maximin S, Caracta P. Malignant peripheral nerve sheath tumor. Radiograpics 2003;23(3):790–4. Hrehorovich PA, Franke HR, Maximin S, Caracta P. Malignant peripheral nerve sheath tumor. Radiograpics 2003;23(3):790–4.
5.
Zurück zum Zitat Geller DS, Gebhardt M. Malignant peripheral nerve sheath tumors. Electronic Sarcoma Update Newsletter [Internet]. 2006; 3 (3). Geller DS, Gebhardt M. Malignant peripheral nerve sheath tumors. Electronic Sarcoma Update Newsletter [Internet]. 2006; 3 (3).
6.
Zurück zum Zitat Patil K, Mahima VG, Ambika L. Malignant peripheral nerve sheath tumour: an elusive diagnosis. Indian J Dental Res. 2007;18(1):19–22.CrossRef Patil K, Mahima VG, Ambika L. Malignant peripheral nerve sheath tumour: an elusive diagnosis. Indian J Dental Res. 2007;18(1):19–22.CrossRef
7.
Zurück zum Zitat Huang JH, Zhang J, Zager EL. Diagnosis and treatment options for nerve sheath tumors. Expert Rev Neurother. 2005;5(4):515–23.PubMedCrossRef Huang JH, Zhang J, Zager EL. Diagnosis and treatment options for nerve sheath tumors. Expert Rev Neurother. 2005;5(4):515–23.PubMedCrossRef
8.
Zurück zum Zitat Mrugala MM, Batchelor TT, Plotkin SR. Peripheral and cranial nerve sheath tumors. Curr Opin Neurol. 2005;18(5):604–10.PubMedCrossRef Mrugala MM, Batchelor TT, Plotkin SR. Peripheral and cranial nerve sheath tumors. Curr Opin Neurol. 2005;18(5):604–10.PubMedCrossRef
9.
Zurück zum Zitat Hung YW, Tse WL, Cheng HS, Ho PC. Surgical excision for challenging upper limb nerve sheath tumours: a single centre retrospective review of treatment results. Hong Kong Med J. 2010;16(4):287–91.PubMed Hung YW, Tse WL, Cheng HS, Ho PC. Surgical excision for challenging upper limb nerve sheath tumours: a single centre retrospective review of treatment results. Hong Kong Med J. 2010;16(4):287–91.PubMed
10.
Zurück zum Zitat Ogose A, Hotta T, Morita T, Higuchi T, Umezu H, Imaizumi S, et al. Diagnosis of peripheral nerve sheath tumors around the pelvis. Jpn J Clin Oncol. 2004;34(7):405–13.PubMedCrossRef Ogose A, Hotta T, Morita T, Higuchi T, Umezu H, Imaizumi S, et al. Diagnosis of peripheral nerve sheath tumors around the pelvis. Jpn J Clin Oncol. 2004;34(7):405–13.PubMedCrossRef
11.
Zurück zum Zitat Ball AB, Fisher C, Pittam M, Watkins RM, Westbury G. Diagnosis of soft tissue tumours by Tru-Cut biopsy. Brit J Surg. 1990;77(7):756–8.PubMedCrossRef Ball AB, Fisher C, Pittam M, Watkins RM, Westbury G. Diagnosis of soft tissue tumours by Tru-Cut biopsy. Brit J Surg. 1990;77(7):756–8.PubMedCrossRef
13.
Zurück zum Zitat Mitsuyoshi G, Naito N, Kawai A, Kunisada T, Yoshida A, Yanai H, et al. Accurate diagnosis of musculoskeletal lesions by core needle biopsy. J Surg Oncol. 2006;94(1):21–7.PubMedCrossRef Mitsuyoshi G, Naito N, Kawai A, Kunisada T, Yoshida A, Yanai H, et al. Accurate diagnosis of musculoskeletal lesions by core needle biopsy. J Surg Oncol. 2006;94(1):21–7.PubMedCrossRef
14.
Zurück zum Zitat Yao L, Nelson SD, Seeger LL, Eckardt JJ, Eilber FR. Primary musculoskeletal neoplasms: effectiveness of core-needle biopsy. Radiology. 1999;212(3):682–6.PubMedCrossRef Yao L, Nelson SD, Seeger LL, Eckardt JJ, Eilber FR. Primary musculoskeletal neoplasms: effectiveness of core-needle biopsy. Radiology. 1999;212(3):682–6.PubMedCrossRef
15.
Zurück zum Zitat Carrino JA, Khurana B, Ready JE, Silverman SG, Winalski CS. Magnetic resonance imaging-guided percutaneous biopsy of musculoskeletal lesions. J Bone Joint Surg Am. 2007;89(10):2179–87.PubMedCrossRef Carrino JA, Khurana B, Ready JE, Silverman SG, Winalski CS. Magnetic resonance imaging-guided percutaneous biopsy of musculoskeletal lesions. J Bone Joint Surg Am. 2007;89(10):2179–87.PubMedCrossRef
16.
Zurück zum Zitat Friedrich RE, Kluwe L, Funsterer C, Mautner VF. Malignant peripheral nerve sheath tumors (MPNST) in neurofibromatosis type 1 (NF1): diagnostic findings on magnetic resonance images and mutation analysis of the NF1 gene. Anticancer Res. 2005;25(3A):1699–702.PubMed Friedrich RE, Kluwe L, Funsterer C, Mautner VF. Malignant peripheral nerve sheath tumors (MPNST) in neurofibromatosis type 1 (NF1): diagnostic findings on magnetic resonance images and mutation analysis of the NF1 gene. Anticancer Res. 2005;25(3A):1699–702.PubMed
17.
Zurück zum Zitat Pilavaki M, Chourmouzi D, Kiziridou A, Skordalaki A, Zarampoukas T, Drevelengas A. Imaging of peripheral nerve sheath tumors with pathologic correlation: pictorial review. Eur J Radiol. 2004;52(3):229–39.PubMedCrossRef Pilavaki M, Chourmouzi D, Kiziridou A, Skordalaki A, Zarampoukas T, Drevelengas A. Imaging of peripheral nerve sheath tumors with pathologic correlation: pictorial review. Eur J Radiol. 2004;52(3):229–39.PubMedCrossRef
18.
Zurück zum Zitat Furniss D, Swan MC, Morritt DG, Lim J, Khanna T, Way BL, et al. A 10-year review of benign and malignant peripheral nerve sheath tumors in a single center: clinical and radiographic features can help to differentiate benign from malignant lesions. Plast Reconstr Surg. 2008;121(2):529–33.PubMedCrossRef Furniss D, Swan MC, Morritt DG, Lim J, Khanna T, Way BL, et al. A 10-year review of benign and malignant peripheral nerve sheath tumors in a single center: clinical and radiographic features can help to differentiate benign from malignant lesions. Plast Reconstr Surg. 2008;121(2):529–33.PubMedCrossRef
19.
Zurück zum Zitat Ogose A, Hotta T, Morita T, Yamamura S, Hosaka N, Kobayashi H, et al. Tumors of peripheral nerves: correlation of symptoms, clinical signs, imaging features, and histologic diagnosis. Skelet Radiol. 1999;28(4):183–8.CrossRef Ogose A, Hotta T, Morita T, Yamamura S, Hosaka N, Kobayashi H, et al. Tumors of peripheral nerves: correlation of symptoms, clinical signs, imaging features, and histologic diagnosis. Skelet Radiol. 1999;28(4):183–8.CrossRef
20.
Zurück zum Zitat Wakely PE, Jr., Ali SZ, Bishop JA. The cytopathology of malignant peripheral nerve sheath tumor: a report of 55 fine-needle aspiration cases. Cancer Cytopathol. 2012. Wakely PE, Jr., Ali SZ, Bishop JA. The cytopathology of malignant peripheral nerve sheath tumor: a report of 55 fine-needle aspiration cases. Cancer Cytopathol. 2012.
21.
Zurück zum Zitat Klijanienko J, Caillaud JM, Lagace R, Vielh P. Cytohistologic correlations of 24 malignant peripheral nerve sheath tumor (MPNST) in 17 patients: the Institut Curie experience. Diagn Cytopathol. 2002;27(2):103–8.PubMedCrossRef Klijanienko J, Caillaud JM, Lagace R, Vielh P. Cytohistologic correlations of 24 malignant peripheral nerve sheath tumor (MPNST) in 17 patients: the Institut Curie experience. Diagn Cytopathol. 2002;27(2):103–8.PubMedCrossRef
22.
Zurück zum Zitat Zerbino DD. Biopsy: its history, current and future outlook. Likars’ka sprava/Ministerstvo okhorony zdorov’ia Ukrainy. 1994(3–4):1-9. Zerbino DD. Biopsy: its history, current and future outlook. Likars’ka sprava/Ministerstvo okhorony zdorov’ia Ukrainy. 1994(3–4):1-9.
23.
Zurück zum Zitat Bermejo A, De Bustamante TD, Martinez A, Carrera R, Zabia E, Manjon P. MR imaging in the evaluation of cystic-appearing soft-tissue masses of the extremities. Radiographics. 2013;33(3):833–55.PubMedCrossRef Bermejo A, De Bustamante TD, Martinez A, Carrera R, Zabia E, Manjon P. MR imaging in the evaluation of cystic-appearing soft-tissue masses of the extremities. Radiographics. 2013;33(3):833–55.PubMedCrossRef
24.
Zurück zum Zitat Robinson E, Bleakney RR, Ferguson PC, O’Sullivan B. Oncodiagnosis panel: 2007—multidisciplinary management of soft-tissue sarcoma. Radiographics. 2008;28(7):2069–86.PubMedCrossRef Robinson E, Bleakney RR, Ferguson PC, O’Sullivan B. Oncodiagnosis panel: 2007—multidisciplinary management of soft-tissue sarcoma. Radiographics. 2008;28(7):2069–86.PubMedCrossRef
25.
Zurück zum Zitat Altuntas AO, Slavin J, Smith PJ, Schlict SM, Powell GJ, Ngan S, et al. Accuracy of computed tomography guided core needle biopsy of musculoskeletal tumours. ANZ J Surg. 2005;75(4):187–91.PubMedCrossRef Altuntas AO, Slavin J, Smith PJ, Schlict SM, Powell GJ, Ngan S, et al. Accuracy of computed tomography guided core needle biopsy of musculoskeletal tumours. ANZ J Surg. 2005;75(4):187–91.PubMedCrossRef
26.
Zurück zum Zitat Sarzi-Puttini P, Vellucci R, Zuccaro SM, Cherubino P, Labianca R, Fornasari D. The appropriate treatment of chronic pain. Clin Drug Investig. 2012;32 Suppl 1:21–33.CrossRef Sarzi-Puttini P, Vellucci R, Zuccaro SM, Cherubino P, Labianca R, Fornasari D. The appropriate treatment of chronic pain. Clin Drug Investig. 2012;32 Suppl 1:21–33.CrossRef
29.
Zurück zum Zitat Artico M, Cervoni L, Wierzbicki V, D’Andrea V, Nucci F. Benign neural sheath tumours of major nerves: characteristics in 119 surgical cases. Acta Neurochir. 1997;139(12):1108–16.PubMedCrossRef Artico M, Cervoni L, Wierzbicki V, D’Andrea V, Nucci F. Benign neural sheath tumours of major nerves: characteristics in 119 surgical cases. Acta Neurochir. 1997;139(12):1108–16.PubMedCrossRef
30.
Zurück zum Zitat Donner TR, Voorhies RM, Kline DG. Neural sheath tumors of major nerves. J Neurosurg. 1994;81(3):362–73.PubMedCrossRef Donner TR, Voorhies RM, Kline DG. Neural sheath tumors of major nerves. J Neurosurg. 1994;81(3):362–73.PubMedCrossRef
31.
Zurück zum Zitat Kim DH, Murovic JA, Tiel RL, Kline DG. Operative outcomes of 546 Louisiana State University Health Sciences Center peripheral nerve tumors. Neurosurg Clin N Am. 2004;15(2):177–92.PubMedCrossRef Kim DH, Murovic JA, Tiel RL, Kline DG. Operative outcomes of 546 Louisiana State University Health Sciences Center peripheral nerve tumors. Neurosurg Clin N Am. 2004;15(2):177–92.PubMedCrossRef
32.
Zurück zum Zitat Gachiani J, Kim D, Nelson A, Kline D. Surgical management of malignant peripheral nerve sheath tumors. Neurosurg Focus. 2007;22(6):E13.PubMed Gachiani J, Kim D, Nelson A, Kline D. Surgical management of malignant peripheral nerve sheath tumors. Neurosurg Focus. 2007;22(6):E13.PubMed
33.
Zurück zum Zitat Bruner JM. Peripheral nerve sheath tumors of the head and neck. Semin Diagn Pathol. 1987;4(2):136–49.PubMed Bruner JM. Peripheral nerve sheath tumors of the head and neck. Semin Diagn Pathol. 1987;4(2):136–49.PubMed
34.
Zurück zum Zitat Stucky CC, Johnson KN, Gray RJ, Pockaj BA, Ocal IT, Rose PS, et al. Malignant peripheral nerve sheath tumors (MPNST): the Mayo Clinic experience. Ann Surg Oncol. 2012;19(3):878–85.PubMedCrossRef Stucky CC, Johnson KN, Gray RJ, Pockaj BA, Ocal IT, Rose PS, et al. Malignant peripheral nerve sheath tumors (MPNST): the Mayo Clinic experience. Ann Surg Oncol. 2012;19(3):878–85.PubMedCrossRef
Metadaten
Titel
Accuracy and complications of CT-guided core needle biopsy of peripheral nerve sheath tumours
verfasst von
Marcus Pianta
Eric Chock
Stephen Schlicht
David McCombe
Publikationsdatum
01.09.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Skeletal Radiology / Ausgabe 9/2015
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-015-2185-6

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