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[Radionuclide-guided minimally invasive rib biopsy for metastases]
T van Mesdag1, G M M Gommans, J W D de Waard
1Afd. Heelkunde, Westfries Gasthuis, Postbus 600, 1620 AR Hoorn.
Objective:
To determine the feasibility of radionuclide-guided surgical rib biopsy in patients in whom a local metastasis is suspected.
Design:
Descriptive.
Method:
In eight patients (three men and five women) with a known primary carcinoma, radionuclide-guided surgical rib biopsy was performed because a local metastasis was suspected. The skin was marked on the basis of a technetium-99m-(99mTc)-medronate scintigram. During surgery, a gamma probe was used to look for the hot spot in the rib in the vicinity of the skin marking; this hot spot was then minimally excised and submitted for pathological examination.
Results:
In all patients, the radionuclide-guided rib biopsy resulted in an unequivocal histopathologic diagnosis: tumour metastasis (n = 2), necrosis (n = 1), old fracture (n = 5).
Conclusion:
Radionuclide-guided surgical bone biopsy has been shown to be a specific, simple, minimally invasive technique for obtaining a representative histological specimen with little stress on the patient. This technique can be used in every hospital that is equipped to carry out the sentinal node procedure in case of breast cancer or melanoma.