The Role of “Core-Biopsy” in the Diagnostics of Pelvic Tumors

Abstract

Tumors of the small pelvis represent a wide range of different nosological units and occur at any age. Distinguish between congenital and acquired neoplasms, which can not only come from the tissues of the small pelvis, but also involve them in distant metastases in malignant neoplasms of various localizations. The most sparing minimally invasive method of morphological verification is the puncture core biopsy under the control of ultrasound navigation, however, the diagnostic value of the method, sensitivity and specificity vary widely in various forms of small pelvic tumors and depending on the experience of the institution. Material and methods. In the Department of Oncogynecology of the Tashkent City Branch of the Republican Specialized Scientific and Practical Medical Center of Oncology and Radiology, in the period from 2018 to 2023, core-needle biopsies were performed in 82 patients with primary tumor and metastatic lesions of the small pelvis. 40 standard, 42 multifocal biopsies were performed - 30 from two sites, 12 from three. Results. The final histological diagnosis by ultrasound-guided core-needle biopsy of the small pelvis was established in 73 (89%) patients, out of the total number of patients. In 60 (82.2%) patients, a malignant tumor was diagnosed, in 13 (17.8%) the process was benign. Repeated biopsies were performed in 4 patients, which made it possible to establish the final diagnosis. 9 patients underwent diagnostic laparoscopy and open biopsy of the tumor due to the ineffectiveness of core-needle biopsy. All patients received a final diagnosis. Conclusion. Ultrasound-guided core biopsy of a pelvic tumor is a safe and reliable method of morphological verification, characterized by high diagnostic accuracy. The overall effectiveness of the technique is 83%. In the presence of a zone of tumor necrosis, the use of multifocal biopsy increases the information content of the biopsy material. In the group of patients with suspected lymphoproliferative disease complicated by the course of the tumor process, if the first core-biopsy attempt is not informative, an open tumor biopsy is indicated.