Skip to main content

Advertisement

SpringerLink
Log in

Accuracy and complications of CT-guided core needle biopsy of peripheral nerve sheath tumours

  • Scientific Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objective

This single-centre study retrospectively reviews the complications in patients that have occurred following peripheral nerve sheath tumour biopsy, and assesses whether there is an association with biopsy technique or underlying lesion characteristics.

Materials and methods

41 consecutive core needle biopsies of proven peripheral nerve sheath tumours over a 2-year period in a tertiary teaching hospital were reviewed. Patient demographics and symptoms, tumour characteristics and radiological appearances were recorded. Biopsy and surgical histology were correlated, and post-biopsy and surgical complications analyzed.

Results

41 biopsies were performed in 38 patients. 68 % schwannomas, 24 % neurofibromas and 7 % malignant peripheral nerve sheath tumours. Biopsy histology correlated with surgery in all cases. 71 % of lesions were surgically excised. 60 % of patients reported pain related to their lesion. Following the biopsy, 12 % reported increased pain, which resolved in all cases. Pain exacerbation was noted in tumours smaller in size, more superficial and in closer proximity of the biopsy needle tip to the traversing nerve. Number of biopsy needle passes was not associated with an increased incidence of procedure-related pain.

Conclusion

Core biopsy of a suspected peripheral nerve sheath tumour may be performed safely before excisional surgery to confirm lesion histology and assist prognosis. There is excellent correlation between core biopsy and excised surgical specimen histology. The most common complication of pain exacerbation is seen in a minority and is temporary, and more likely with smaller, more superficial lesions and a closer needle-tip to traversing nerve distance during biopsy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Notes

  1. 99% total due to rounding.

References

  1. Rodriguez FJ, Folpe AL, Giannini C, Perry A. Pathology of peripheral nerve sheath tumors: diagnostic overview and update on selected diagnostic problems. Acta Neuropathol. 2012;123(3):295–319.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Kim DH, Murovic JA, Tiel RL, Moes G, Kline DG. A series of 397 peripheral neural sheath tumors: 30-year experience at Louisiana State University Health Sciences Center. J Neurosurg. 2005;102(2):246–55.

    Article  PubMed  Google Scholar 

  3. Levi AD, Ross AL, Cuartas E, Qadir R, Temple HT. The surgical management of symptomatic peripheral nerve sheath tumors. Neurosurgery. 2010;66(4):833–40.

    Article  PubMed  Google Scholar 

  4. Hrehorovich PA, Franke HR, Maximin S, Caracta P. Malignant peripheral nerve sheath tumor. Radiograpics 2003;23(3):790–4.

  5. Geller DS, Gebhardt M. Malignant peripheral nerve sheath tumors. Electronic Sarcoma Update Newsletter [Internet]. 2006; 3 (3).

  6. Patil K, Mahima VG, Ambika L. Malignant peripheral nerve sheath tumour: an elusive diagnosis. Indian J Dental Res. 2007;18(1):19–22.

    Article  Google Scholar 

  7. Huang JH, Zhang J, Zager EL. Diagnosis and treatment options for nerve sheath tumors. Expert Rev Neurother. 2005;5(4):515–23.

    Article  PubMed  Google Scholar 

  8. Mrugala MM, Batchelor TT, Plotkin SR. Peripheral and cranial nerve sheath tumors. Curr Opin Neurol. 2005;18(5):604–10.

    Article  PubMed  Google Scholar 

  9. Hung YW, Tse WL, Cheng HS, Ho PC. Surgical excision for challenging upper limb nerve sheath tumours: a single centre retrospective review of treatment results. Hong Kong Med J. 2010;16(4):287–91.

    CAS  PubMed  Google Scholar 

  10. Ogose A, Hotta T, Morita T, Higuchi T, Umezu H, Imaizumi S, et al. Diagnosis of peripheral nerve sheath tumors around the pelvis. Jpn J Clin Oncol. 2004;34(7):405–13.

    Article  PubMed  Google Scholar 

  11. Ball AB, Fisher C, Pittam M, Watkins RM, Westbury G. Diagnosis of soft tissue tumours by Tru-Cut biopsy. Brit J Surg. 1990;77(7):756–8.

    Article  CAS  PubMed  Google Scholar 

  12. Sung KS, Seo SW, Shon MS. The diagnostic value of needle biopsy for musculoskeletal lesions. Int Orthop. 2009;33(6):1701–6.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Mitsuyoshi G, Naito N, Kawai A, Kunisada T, Yoshida A, Yanai H, et al. Accurate diagnosis of musculoskeletal lesions by core needle biopsy. J Surg Oncol. 2006;94(1):21–7.

    Article  PubMed  Google Scholar 

  14. Yao L, Nelson SD, Seeger LL, Eckardt JJ, Eilber FR. Primary musculoskeletal neoplasms: effectiveness of core-needle biopsy. Radiology. 1999;212(3):682–6.

    Article  CAS  PubMed  Google Scholar 

  15. Carrino JA, Khurana B, Ready JE, Silverman SG, Winalski CS. Magnetic resonance imaging-guided percutaneous biopsy of musculoskeletal lesions. J Bone Joint Surg Am. 2007;89(10):2179–87.

    Article  PubMed  Google Scholar 

  16. Friedrich RE, Kluwe L, Funsterer C, Mautner VF. Malignant peripheral nerve sheath tumors (MPNST) in neurofibromatosis type 1 (NF1): diagnostic findings on magnetic resonance images and mutation analysis of the NF1 gene. Anticancer Res. 2005;25(3A):1699–702.

    PubMed  Google Scholar 

  17. Pilavaki M, Chourmouzi D, Kiziridou A, Skordalaki A, Zarampoukas T, Drevelengas A. Imaging of peripheral nerve sheath tumors with pathologic correlation: pictorial review. Eur J Radiol. 2004;52(3):229–39.

    Article  CAS  PubMed  Google Scholar 

  18. Furniss D, Swan MC, Morritt DG, Lim J, Khanna T, Way BL, et al. A 10-year review of benign and malignant peripheral nerve sheath tumors in a single center: clinical and radiographic features can help to differentiate benign from malignant lesions. Plast Reconstr Surg. 2008;121(2):529–33.

    Article  CAS  PubMed  Google Scholar 

  19. Ogose A, Hotta T, Morita T, Yamamura S, Hosaka N, Kobayashi H, et al. Tumors of peripheral nerves: correlation of symptoms, clinical signs, imaging features, and histologic diagnosis. Skelet Radiol. 1999;28(4):183–8.

    Article  CAS  Google Scholar 

  20. Wakely PE, Jr., Ali SZ, Bishop JA. The cytopathology of malignant peripheral nerve sheath tumor: a report of 55 fine-needle aspiration cases. Cancer Cytopathol. 2012.

  21. Klijanienko J, Caillaud JM, Lagace R, Vielh P. Cytohistologic correlations of 24 malignant peripheral nerve sheath tumor (MPNST) in 17 patients: the Institut Curie experience. Diagn Cytopathol. 2002;27(2):103–8.

    Article  PubMed  Google Scholar 

  22. Zerbino DD. Biopsy: its history, current and future outlook. Likars’ka sprava/Ministerstvo okhorony zdorov’ia Ukrainy. 1994(3–4):1-9.

  23. Bermejo A, De Bustamante TD, Martinez A, Carrera R, Zabia E, Manjon P. MR imaging in the evaluation of cystic-appearing soft-tissue masses of the extremities. Radiographics. 2013;33(3):833–55.

    Article  PubMed  Google Scholar 

  24. Robinson E, Bleakney RR, Ferguson PC, O’Sullivan B. Oncodiagnosis panel: 2007—multidisciplinary management of soft-tissue sarcoma. Radiographics. 2008;28(7):2069–86.

    Article  PubMed  Google Scholar 

  25. Altuntas AO, Slavin J, Smith PJ, Schlict SM, Powell GJ, Ngan S, et al. Accuracy of computed tomography guided core needle biopsy of musculoskeletal tumours. ANZ J Surg. 2005;75(4):187–91.

    Article  PubMed  Google Scholar 

  26. Sarzi-Puttini P, Vellucci R, Zuccaro SM, Cherubino P, Labianca R, Fornasari D. The appropriate treatment of chronic pain. Clin Drug Investig. 2012;32 Suppl 1:21–33.

    Article  CAS  Google Scholar 

  27. Dubuc B. Molecules that produce pain. Ottawa: Institute of Neurosciences, Mental Health and Addiction; [cited 2013]. Available from: http://thebrain.mcgill.ca/flash/d/d_03/d_03_m/d_03_m_dou/d_03_m_dou.html. Accessed 1 June 2015.

  28. Dafny N. Pain principles. Houston: The University of Texas Medical School; [cited 2013]. Available from: http://neuroscience.uth.tmc.edu/s2/chapter06.html. Accessed 1 June 2015.

  29. Artico M, Cervoni L, Wierzbicki V, D’Andrea V, Nucci F. Benign neural sheath tumours of major nerves: characteristics in 119 surgical cases. Acta Neurochir. 1997;139(12):1108–16.

    Article  CAS  PubMed  Google Scholar 

  30. Donner TR, Voorhies RM, Kline DG. Neural sheath tumors of major nerves. J Neurosurg. 1994;81(3):362–73.

    Article  CAS  PubMed  Google Scholar 

  31. Kim DH, Murovic JA, Tiel RL, Kline DG. Operative outcomes of 546 Louisiana State University Health Sciences Center peripheral nerve tumors. Neurosurg Clin N Am. 2004;15(2):177–92.

    Article  PubMed  Google Scholar 

  32. Gachiani J, Kim D, Nelson A, Kline D. Surgical management of malignant peripheral nerve sheath tumors. Neurosurg Focus. 2007;22(6):E13.

    PubMed  Google Scholar 

  33. Bruner JM. Peripheral nerve sheath tumors of the head and neck. Semin Diagn Pathol. 1987;4(2):136–49.

    CAS  PubMed  Google Scholar 

  34. Stucky CC, Johnson KN, Gray RJ, Pockaj BA, Ocal IT, Rose PS, et al. Malignant peripheral nerve sheath tumors (MPNST): the Mayo Clinic experience. Ann Surg Oncol. 2012;19(3):878–85.

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The author(s) declare that they have no competing interests.

Author information

Authors and Affiliations

  1. St Vincent’s Hospital, 41 Victoria Parade, Fitzroy, 3065, VIC, Australia

    Marcus Pianta, Eric Chock & Stephen Schlicht

  2. St Vincent’s Hospital and Victorian Hand Surgery Associates, Victoria, Australia

    David McCombe

Authors
  1. Marcus Pianta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eric Chock
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stephen Schlicht
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. David McCombe
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marcus Pianta.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pianta, M., Chock, E., Schlicht, S. et al. Accuracy and complications of CT-guided core needle biopsy of peripheral nerve sheath tumours. Skeletal Radiol 44, 1341–1349 (2015). https://doi.org/10.1007/s00256-015-2185-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-015-2185-6

Keywords

Search

Navigation