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Sarcoma Biopsy Technique — SCE Medical Oncology MCQ

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ModerateSarcomaSarcoma Biopsy TechniqueSCE Medical Oncology

A 30-year-old man presents with a rapidly growing thigh mass. MRI shows a large soft tissue mass with features concerning for high-grade sarcoma. The surgeon plans a biopsy. What biopsy technique is preferred and why is the approach critical?

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Correct answer: E — Core needle biopsy (or incisional biopsy by the operating surgeon) placed along the planned definitive surgical incision — incorrect biopsy tract placement can contaminate tissue planes and compromise subsequent limb-sparing surgery

Sarcoma biopsy technique and placement are critical: (1) core needle biopsy (preferred — less morbidity, accurate in >90%) or incisional biopsy (if core biopsy non-diagnostic), (2) biopsy track must be placed along the planned definitive surgical incision (to allow excision of the track en-bloc with the tumour), (3) performed at or in consultation with the treating sarcoma centre. Poorly planned biopsies (transverse incisions, contamination of uninvolved compartments) can compromise limb-sparing surgery and necessitate amputation. NICE mandates sarcoma referral to specialist centres.

Reference: NICE NG Sarcoma; ESMO 2024 STS; BSG Sarcoma Guidelines