Roa, Mohana
(2006)
The incidence of malignant infiltration in human osteosarcoma biopsy tract.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background: Osteosarcoma is the most common non-haemopoetic primary bone
malignancy afflicting the young. Biopsy remains the gold standard in the confirmation of
the diagnosis. The placement of the biopsy is of utmost importance as the tract is
removed en bloc with the tumour during limb sparing surgery, with the assumption that it
is contaminated by the tumour. Tissue conservation, to ensure adequate soft tissue cover,
and preservation of function still remains a challenge for musculoskeletal oncology
surgeons.
This study aims to investigate the incidence of tumour infiltration in osteosarcoma biopsy
tract, namely in the pseudocapsule, surrounding muscle, fascia, subcutaneous tissue and
skin; in order to explore the margin of tumour infiltration for safe resection of the biopsy
scar.
Materials and methods: This is a prospective cross sectional study, carried out from
May 2003 to March 2005 at Hospital Universiti Sains Malaysia, Kubang Kerian,
Kelantan. A total of twenty six cases which had undergone either limb salvage surgery or
amputation by the Orthopaedic Oncology and Reconstructive Unit, School of Medical
Sciences, University Science Malaysia, with the histopathological diagnosis of
osteosarcoma were collected. The biopsy tracts were submitted as a whole and examined
histologically for tumour presence.
Results: Of the 26 cases examined, twenty one cases (80.8%) did not show any tumour
infiltration in the biopsy tract. One case (3.8%) had tumour infiltration in the
pseudocapsule, two cases (7. 7%) had infiltration to the muscle and another two cases
(7.7%) had infiltration up to the subcutaneous tissue. None had skin infiltration.
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