Biopsy of Musculoskeletal Tumors; Current Concepts Review

Context: Appropriate management of soft-tissue and bone tumor needs correct diagnosis. Sometimes, diagnosis can be made by history, physical examination and imaging. An incompetently performed biopsy not only may fail in making the proper diagnosis, but also has a negative impact on survival and local control. Evidence Acquisition: To reach the most accurate information in the field of biopsy of the musculoskeletal tumor, based on the intensive literature review of the most prestigious journals and textbooks in the field of the musculoskeletal tumor surgery and our experiences in the only referral center in our country for more than 25 years, this current concept review was prepared. Results: Fine needle aspiration (FNA) has the highest accuracy in homogenous tumor as well as malignant myeloma and metastatic carcinoma. Core needle biopsy (CNB) is usually selected as the first biopsy modality. Incisional biopsy is indicated in difficult cases when a larger specimen is necessary for diagnosis. In malignant bone tumors, soft tissue component is as much representative as bony component. Conclusions: Biopsy should be considered as a final diagnostic procedure. Not all bone and soft tissue lesions need biopsy. FNA, CNB and incisional biopsy should be performed as their precisely defined indications.