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Role of transvaginal ultrasound-guided biopsy in gynecology
  1. Floriana Mascilini,
  2. Lorena Quagliozzi,
  3. Francesca Moro,
  4. Maria Cristina Moruzzi,
  5. Ilaria De Blasis,
  6. Valentina Paris,
  7. Giovanni Scambia,
  8. Anna Fagotti and
  9. Antonia Carla Testa
  1. Dipartimento per le Scienze della salute della donna e del bambino, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Gynecologic Oncology, Rome, Italy
  1. Correspondence to Dr Floriana Mascilini, Dipartimento per le Scienze della salute della donna e del bambino, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Gynecologic Oncology, Rome 00168, Italy; floriana_mascilini{at}hotmail.com

Abstract

Background Ultrasound-guided biopsy is an easy technique for obtaining tissue samples. It is commonly used for different types of tumors, such as breast and prostate cancers, in order to plan early and adequate treatment.

Objective To evaluate the indications, adequacy, and safety of transvaginal ultrasound-guided biopsy in women with pelvic lesions suspected of gynecologic malignancy.

Methods A retrospective study including all patients who had undergone transvaginal ultrasound-guided biopsy between April 2015 and May 2018 was carried out at the division of gynecologic oncology. Inclusion criteria were the presence at imaging of abdominal or pelvic tumors in patients considered not ideal candidates for primary gynecological surgery, or the origin and/or nature of the tumor was unclear and further management required histological verification. Patients with planned surgery were excluded from the study. Transvaginal biopsies were performed with a 18 G/25 cm core-cut biopsy needle and histology was obtained. Tru-cut biopsies were performed using an automatic bioptic gun with a 18 G/25 cm core-cut biopsy needle. Results are presented as absolute frequency (percentage) for nominal variables and as median (range) for continuous variables.

Results A total of 62 women were analyzed. An adequate sample for histological analysis was obtained in all cases. Histopathological examinations showed 24 (38.7%) benign lesions (fibrosis, inflammation, uterine or ovarian myoma) and 38 (61.3%) malignant tumors, distributed as follows: 34 (89.5%) malignant gynecological lesions and 4 (10.5%) non-gynecological malignant tumors. Among the malignant lesions, there were 12/38 (31.6%) primary tumors, 24/38 (63.2%) recurrent tumors, and 2/38 (5.3%) metastases from non-genital cancer. Ten patients eventually underwent surgery. Final histology was not in agreement with the results from transvaginal ultrasound-guided biopsy in 2 of 10 patients (20%); in particular, benign disease at transvaginal ultrasound-guided biopsy was malignant at final histology (two cases of recurrence of cervical cancer). Three patients (4.8%) had pain during the procedure, which was controlled by oral analgesic therapy and lasted for no longer than 10 min. No major complications were registered.

Conclusions Transvaginal ultrasound-guided biopsy is a minimally invasive method to obtain adequate material for histological diagnosis and could avoid unnecessary surgical procedures, costly CT-guided procedures, or prolonged waiting times.

  • genital neoplasms, female
  • radiology, interventional
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Footnotes

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  • Contributors FMa, LQ designed the study, carried out patient recruitment, data analysis and interpretation, statistical analysis, and wrote the report. AF, ACT, and GS supervised the whole process. FMo, MCM, VP, IDB, ACT, AF, and GS participated in patient recruitment. VP, MCM, FMo, and IDB contributed to collection and organization of the data. All authors approved the final report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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