The Role of Fine Needle Aspiration Biopsy in the Diagnosis and Management of Osteosarcoma

Abstract

retrospectively reviewed our experience with ne needle aspiration biopsy ( FN AB) in the & We diagnosis and management of skeletal osteosarcoma. T he bi-institutional study sample involved 30 consecutive aspirates from 29 patients ( 28 primary tumors, 1 pulmonary metastasis, 1 local recurrence) . T here were 17 children and 12 adults. T wo aspirates were unsatisf actory for diagnosis. Of the adequate primary osteosarcoma cases analyzed by FN A B, 24 of 26 were diagnosed as osteosarcoma. A ll pediatric cases were correctly interpreted as osteosarcoma and treated appropriately. T here were 2 incomplete diagnoses. A secondary osteosarcoma arising within an otherwise clinically, radiologically, and histolog ically typical giant cell tumor ( malignant giant cell tumor) was not diagnosed preoperatively on FN AB due to nonrepresentative sampling. Chronolog ically, the rst patient with osteosarcoma analyzed by FN AB was diagnosed simply as ''spindle cell neoplasm.'' N o complications resulted from the procedure. With adequate clinical and radiologic correlation, FN AB represents a technically, easily performed, cost-eå ective, and accurate procedure f or establishing the diagnosis of skeletal osteosarcoma. Immediate interpretation of aspirated material allows f or therapy planning and oncolog ic consultation at the initial clinic visit.