Incisional Biopsy and Seeding in Hamster Cheek Pouch Carcinoma

Abstract

Surgical blades were contaminated by doing incisional biopsies on DMBA-induced cheek pouch carcinomas in hamsters. Contaminated blades were then used to: (1) make cytologic smears; (2) make incisions in the mucosal surface of the lower lip; (3) make incisions in the ventral surface of the tongue; (4) make incisions in the untreated left cheek pouch; and (5) make incisions in the pre-shaved back. One group of animals was killed three hr post-surgery. The second group was killed seven wk post-surgery. Tissues were excised and processed for microscopic study. Malignant cells were found in many of the incision sites of animals from the first group. In the animals of the second group, several tumors growing from the transplanted tumor cells were observed in the incision sites of the lower lips and the tongue. None was observed in the incision sites of the left cheek pouch or the back. Cervical lymph node metastases were found in approximately 50% of the animals of the second group.

Oral cavity squamous cell carcinoma survival by biopsy type: a cancer registry study

“…[9][10][11] Given that the great majority of oral SCC biopsies are of the incisional biopsy type -84% in our study -the question of biopsy-induced carcinoma spread is certainly an important one to answer as it may affect the survival of the majority of oral SCC patients. However, excisional biopsies may complicate margin localization when further excisions are required, and may require disfiguring and complicated surgery, which proves unnecessary when the lesion turns out to have been benign.…”

“…They have shown that contamination of the surgical instrument with cancer cells did occur during incision of malignant lesions 10 and that malignant cancer spread can occur following an incisional biopsy procedure. 9,10 Interestingly, other animal studies of extraoral SCCs failed to support this finding.…”

“…These concerns have been supported by a number of animal and human studies which have recommended that incisional biopsies should not be used on suspected malignant lesions. [9][10][11] This 378 ª 2010 Australian Dental Association…”

Diagnostic Modalities for Squamous Cell Carcinoma: An Extensive Review of Literature-Considering Toluidine Blue as a Useful Adjunct

“…However, a number of clinicians are concerned that this procedure may spread cancer cells beyond the borders of tumor into the surrounding normal tissue; thus, promoting local spread as well as increasing the potential for metastasis. It has been indicated that surgical trauma inflicted on malignant tumors may increase their metastatic potency [80,81]. The major physical barriers to the migration of tumor cells during this process are connective tissue and basement membrane.…”

“…The surgical intervention may destroy these barriers and facilitate invasion of vascular system at the site of the injury. A number of animal studies have been done which revealed that an incision into the oral cancer significantly increased the risk of regional lymph node metastasis [81][82][83]. Recently, it has been reported that there is an increased frequency of neck metastasis from stage I and II SCCs after incisional biopsy [84,85].…”