Overview

The first, critically important step in treating any tumor is to determine the correct diagnosis. Only then can the appropriate treatment be selected. 

Not all conditions require biopsy. Sometimes, the diagnosis can be predicted from the history, physical and imaging studies alone. However, when a biopsy is required, it is very important that a specialist guide the process. Without an understanding of the types of tumors that appear at different locations and their typical appearance, a biopsy performed at a center without experience in musculoskeletal tumors can be misinterpreted.

This is why patients with musculoskeletal tumors should not undergo biopsy without consultation with a musculoskeletal tumor specialist.

Technique

Musculoskeletal tumors can start in the bones or the soft tissues, the biopsy technique is different for each.

For soft tissue tumors large enough to be manually examined, biopsy is often a simple office procedure. This is done with local anesthetic, using a special biopsy needle.

Bone tumors are usually biopsied by a radiologist using a CT scanner to precisely locate the mass. This requires intravenous sedation and is performed as a scheduled procedure. 

“Open" biopsy, where a surgical procedure is performed to obtain a specimen, is rarely necessary nowadays. This is typically performed only if the diagnosis remains uncertain after one or more needle biopsies.