Abstract

Background: Biopsy method of choice is a controversy issue for diagnosis of soft tissue sarcoma which are
traditionally been managed by wide excision surgery and radiotherapy. Chemotherapy is reserved for advanced cases.

Aims & Objective: The objective of study was to evaluate diagnostic accuracy of various modes of biopsy focusing on
image guided core needle biopsy (CNB).

Material and Methods: Current study includes 50 cases of soft tissue sarcoma from January 2010 to October 2012. The
Mode of biopsies included image guided CNB, open and excision biopsy. Effective accuracy of each was determined by
accuracy of biopsy to provide adequate tissue for histopathological and other special examinations like
immunohistochemistry to reach final diagnosis.

Results: Out of total 50 cases CNB was done in 13 cases, open biopsy in 2 cases and in 35 cases excision biopsy was
done. CNB was adequate in 92.31 % cases and 7.69 % cases it was inadequate. Open and excision biopsy were 100 %
adequate.

Conclusion: Image guided CNB is very helpful in early diagnosis and shows high accuracy especially for high-grade
sarcoma. It is less invasive compared to others and differentiate benign from malignant. It is handful when preoperative
diagnosis is essential for planning pre-operative chemotherapy especially in patients with primarily inoperable,
advanced tumour with compromised performance status or recurrent tumour. But it should be properly directed and
representative of whole tumour and require full radiological correlation by experienced hands. Tumours with myxoid
pattern, lipomatous tumours and low grade sarcomas encounters lower diagnostic accuracy on CNB.

Key words: Soft Tissue Sarcoma; Core Needle Biopsy; Excision Biopsy; Preoperative Diagnosis