The approach to tumors of the musculoskeletal system requires

The approach to tumors of the musculoskeletal system requires such information the integration of clinical, laboratory, radiographic and histological aspects for accurate diagnosis and management leading to successful treatment. In this regard, the biopsy is pointed out as a fundamental step, being essential for the definitive diagnosis and to identify the histological pattern of tumor. 1 – 3 Biopsy must offer adequate and representative tissue samples for accurate diagnosis, without however manipulate excessively the lesion in order to avoid modifying the tumor relationship between anatomical compartments and contamination of surrounding tissues with tumor cells. 2 Most authors experienced in the treatment of musculoskeletal tumors advocate removal of the biopsy tract at the time of surgical resection of the tumor, arguing that this path is potentially contaminated by tumor cells.

1 , 4 – 15 The resection practice along biopsy proves to be much more grounded in an empirical sense than backed up by scientific studies. Still, vague questions are raised in various studies, untested hypotheses emerging. Among them, that the attempt to obtain multiple samples of tissue at biopsy would be associated with increased dissemination and consequently higher probability of contamination of the biopsy tract. 7 Another empirically widespread issue is that the percutaneous biopsy technique, by involving less manipulation of the tumor tissue, also implies a lower contamination of the biopsy tract. 4 , 7 , 16 – 18 It has also been observed that the contamination of the biopsy path is more frequent in soft tissue sarcomas than in cartilaginous and osseous lesions.

13 it is also believed that neoadjuvant chemotherapy has a protective effect in the control of tumor infiltration in the biopsy site, 17 , 19 and that this contamination has a negative value in the prognosis of affected patients. 20 The aim of this systematic literature review is to identify the characteristics of tumor contamination in biopsy path of the musculoskeletal system. METHODS A literature search was performed in PubMed, MEDLINE (1966-1996), MEDLINE (1997-2010), LILACS (Latin American and Caribbean Literature on Health Sciences) and SciELO (Scientific Electronic Library Online) databases from August to October 2010.

The search was performed using the intersection of keywords found in DeCS (Descriptors in Health Sciences) and MeSH (Medical Cilengitide Subject Headings): neoplasm seeding and biopsy with their counterparts in English and Spanish at all bases. In addition to these descriptors, we carried out a search with the following intersections of free terms, used because of their relevance to the topic studied: biopsy tract AND musculoskeletal tumors; biopsy tract AND musculoskeletal cancer; and biopsy tract AND musculoskeletal neoplasm, with their corresponding terms in English and Spanish on all databases. Were also consulted the references of selected articles for the search of relevant articles.

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