Fine needle aspiration for the diagnosis and treatment of musculoskleletal tumours

OBJECTIVE: The aim of this study was to evaluate the diagnostic accuracy of FNA and analyse its efficacy in enabling the initiation of treatment in musculoskeletal tumours. METHODS: A total of 130 FNA were performed (94 bone and 36 soft tissue lesions) guided by CT scan (n = 64), ultrasonography (n = 36) and radioscopy (n = 30). Diagnostic yield and accuracy were evaluated. A diagnosis was considered accurate when confirmed by histology or ulterior clinical/imaging evaluation. Exclusion of malignancy or infection was considered as diagnoses. RESULTS: Ninety diagnoses (69.2%) were obtained: 87 (96.7%) were accurate and 3 were wrong. FNA was non-diagnostic in 40 cases (30.8%) but in 15 (11.5%) it has been possible to conclude if the lesion was malignant (n = 6) or benign (n = 9). This method was completely inconclusive in 25 cases (19.2%). CONCLUSION: Despite the low diagnostic yield, accuracy was high. FNA allowed the initiation of treatment in all 87 patients with a correct diagnosis and in 9 in which malignancy was excluded. Two of the 6 biopsies with the information of malignancy were soft tissue lesions. Even here, treatment could be done, as the majority of soft tissue sarcoma protocols begin with surgery. This study validates FNA as a method with a high diagnostic accuracy.