Case 144: How to Biopsy a Sclerotic Bone Lesion Using Regular Biopsy Guns and Needles
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A 77-years old with carcinoma prostate treated 7 years ago, came with a PSMA PET/CT showing a focal sclerotic lesion in the left ischiopubic ramus that had mildly increased in size over 7 years and had an HU of 750.
This was the only lesion and hence he was referred for a CT guided biopsy.
The video discusses the case, the approach to this sclerotic lesion and some basic issues with a biopsy of sclerotic bone lesions
Region: Bony pelvis
Age: 77 years
Findings: One focal sclerotic lesion in the left ischiopubic ramus - HU of 750
Lesion Biopsied: Prone ischiopubic ramus and supine adductor collection
Size of Lesion: 10.5 mm z axis x 8.7 mm
Gun: 11G bone biopsy and 18G Medax 20 mm throw long
No of cores: 4 for histopath
Sedation: Yes
Position & Approach: Prone
Time Taken (marker to wash-out): 10 mins
Complication: None
Level of Difficulty: 4/5
Diagnosis: Metastatic adenocarcinoma from prostate primary
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