Bone biopsy results in patients with a history of malignancy: a case series of 378 patients

Morris, Rhys; Shepherd, Karen; Cribb, Gillian; Singh, Jaspreet; Tyrrell, Prudencia; Cool, Paul

Abstract

Objective
The value of a bone biopsy in patients who present with a bone lesion and past medical history of malignancy is uncertain. The objective of this study was to evaluate the outcome of bone biopsies in patients with a history of a malignancy undergoing bone biopsy of a lesion in a regional bone tumour unit. Secondary outcomes include the assessment of survival in the different outcome groups.

Materials and methods
This was a retrospective study of patients, with a previous malignancy and suspicious bone lesions, who underwent bone biopsy for final diagnosis between March 2010 and September 2019. Results of the biopsy were summarized into 3 groups: confirmed original malignancy, confirmed benign diagnosis, and confirmed new malignancy. Survival analysis of each group was also undertaken.

Results
A total of 378 patients met the inclusion criteria (mean age 64 years, 216 females (57%)). In 250 cases (66%), the original malignancy was confirmed on the bone biopsy; in 128 cases, an alternative diagnosis was confirmed (benign diagnosis in 69 (18%)), and 59 had a new malignancy (16%). Survival was significantly greater for those in whom a benign diagnosis was confirmed (logrank test p = 0.0100).

Conclusion
This study shows that for patients presenting with a suspicious bone lesion, together with a history of malignancy, in a third of cases, the bone biopsy will confirm an alternative diagnosis of a benign lesion or a new malignancy. Survival of these patients will vary significantly depending on the biopsy outcome.

Citation

Morris, R., Shepherd, K., Cribb, G., Singh, J., Tyrrell, P., & Cool, P. (2021). Bone biopsy results in patients with a history of malignancy: a case series of 378 patients. Skeletal Radiology, 50(6), 1111-1116. https://doi.org/10.1007/s00256-020-03652-0

• Journal Article Type: Article
• Online Publication Date: Oct 23, 2020
• Publication Date: 2021-06
• Deposit Date: Jun 20, 2023
• Journal: Skeletal Radiology
• Print ISSN: 0364-2348
• Electronic ISSN: 1432-2161
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 50
• Issue: 6
• Pages: 1111-1116
• DOI: https://doi.org/10.1007/s00256-020-03652-0
• Keywords: Radiology, Nuclear Medicine and imaging
• Additional Information: Received: 13 July 2020; Revised: 13 October 2020; Accepted: 13 October 2020; First Online: 23 October 2020; : ; : The authors declare that they have no conflict of interest.; : All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.