Ultrasound-Guided Tru-Cut Biopsy in Gynecological and Non-Gynecological Pelvic Masses: A Single-Center Experience

Francesca Buonomo; Sofia Bussolaro; Clarice de Almeida Fiorillo; Danilo Oliveira de Souza; Fabiola Giudici; Federico Romano; Andrea Romano; Giuseppe Ricci

doi:10.3390/jcm11092534

Ultrasound-Guided Tru-Cut Biopsy in Gynecological and Non-Gynecological Pelvic Masses: A Single-Center Experience

J Clin Med. 2022 Apr 30;11(9):2534. doi: 10.3390/jcm11092534.

Authors

Francesca Buonomo¹, Sofia Bussolaro², Clarice de Almeida Fiorillo¹, Danilo Oliveira de Souza³, Fabiola Giudici^{2

4}, Federico Romano¹, Andrea Romano⁵, Giuseppe Ricci^{1

2}

Affiliations

¹ Institute for Maternal and Child Health, I.R.C.C.S. "Burlo Garofolo", 34137 Trieste, Italy.
² Department of Medical, Surgery and Health Sciences, University of Trieste, 34127 Trieste, Italy.
³ ELETTRA Sincrotrone Trieste S.C.p.A., S.S. 14 Km 163.5, 34149 Trieste, Italy.
⁴ Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35122 Padova, Italy.
⁵ S.C. (UCO) Anatomia ed Istologia Patologica, Azienda Sanitaria Universitaria Giuliano Isontina, 34148 Trieste, Italy.

Abstract

Aim: The aim of this study was to evaluate the feasibility of adequacy, accuracy, and safety of ultrasound-guided tru-cut biopsy in managing malignant and benign abdominopelvic masses in a selected population and critically discuss some issues in different situations, which deserve some reflections on those practices.

Materials and methods: This is a retrospective study involving 42 patients who underwent transvaginal or transabdominal tru-cut biopsy between August 2017 and November 2021. The inclusion criteria were poor health status or primary inoperable advanced tumor, suspicion of recurrence or metastasis to the ovaries or peritoneum in gynecological and non-gynecological pelvic malignancies. Tissue samples were considered adequate if it was possible to determine the origin of the tumor, and immunohistochemistry could be performed. Diagnostic accuracy was assessed considering the agreement between tru-cut biopsy histology and final postoperative histology.

Results: It total, 44 biopsies were obtained from 42 patients (2 patients had repeat biopsies). The pathologist considered all pathological samples adequate (adequacy 100%). The final histology was consistent with tru-cut biopsy diagnosis in all but 2 cases (diagnostic accuracy 88.2%). If we consider only the cases that have carried out at least two diagnostic samples, accuracy rose to 94.1%. Pathological examinations from tru-cut samples showed 2 benign lesions (4.8%) and 40 malignant tumors (95.2%), divided into 19 advanced primary inoperable ovarian cancers, 7 primary advanced cervical cancers, 4 recurrent endometrial cancers, 3 recurrent cervical cancers, 3 recurrent ovarian cancers, 1 case of primitive peritoneal malignancy (leiomyosarcoma), and 3 non-gynecological cancers with a strong suspicion of metastases at ultrasound (2 cases of ovarian, colorectal cancer metastasis, and 1 case of pelvic site type B lymphoma metastasis). However, one case of minor complication related to the procedure was reported but not significant.

Conclusions: The diagnostic adequacy, accuracy of the tru-cut biopsy, and safety were high. Pathological samples are representative of the disease and suitable for histological and immunohistochemical analysis.

Keywords: gynecological oncological diseases; tru-cut biopsy; ultrasound.

Grants and funding

This work was supported by the Ministry of Health, Rome, Italy, in collaboration with Institute for Maternal and Child Health ‘IRCCS Burlo Garofolo’, Trieste, Italy (RC 8/20). The funder had no role in the design or conduct of the study, collection, management, analysis, or interpretation of the data, the writing of the manuscript.