The value of ultrasound-guided core-needle biopsy in the diagnosis of retroperitoneal sarcomas

This is the authors' abstract. We don't add key points for this paper.

Introduction Soft tissue sarcomas are a diverse group of tumours located in various regions of the body. A particularly challenging diagnostic localization is the retroperitoneal space, due to the difficulties in accessing this area for biopsy and the associated challenges in selecting the appropriate technique to obtain reliable histopathological material that determines further treatment. Material The analysis data from 177 consecutive patients who underwent surgical intervention for sarcomas of the retroperitoneal space in the Department of Soft Tissue, Bone and Melanoma Tumors between 2017 and 2023. Results A total of 177 patients were subjected to biopsy analysis. Tissue material was obtained from all patients through biopsy in order to confirm the diagnosis of retroperitoneal sarcoma. Thirty patients underwent an open biopsy, two patients underwent a core-needle biopsy under CT guidance, and 144 patients underwent an ultrasound-guided biopsy. The histological subtype changed in 40% of cases, while the grade of malignancy changed in 30% in final postoperative diagnosis. Complications after biopsy requiring surgery occurred in one case. Furthermore, there was no alteration in the diagnosis from malignant to benign lesion in the postoperative material. Conclusions Computed tomography (CT-) or ultrasound-guided core-needle biopsy is preferred and safe procedure to establish pathologic diagnosis in soft tissue tumors, however still open biopsy can be considered in selected cases. Core needle biopsy can establish a preoperative diagnosis and does not involve surgery or general anaesthesia. The open biopsy procedure should be considered a last resort, to be used only when a minimally invasive core-needle biopsy cannot be performed safely. Further research is required to determine the most suitable biopsy site from the tumour to minimise the variation in the degree of malignancy and subtype in the final diagnosis.