What's New in Musculoskeletal Oncology
Kristy L. Weber, MD

Advances in the diagnosis, treatment, and prevention of cancer have been rapid on both the basic and the clinical research front. This review will highlight recent discoveries and innovations and also will discuss refinements in established techniques in the field of musculoskeletal oncology. The dates and locations of future tumor-related meetings are included, and relevant web sites are listed.

The Role of Interventional Radiology in Musculoskeletal Oncology

The diagnosis and treatment of musculoskeletal tumors have been increasingly aided by techniques used by interventional radiologists. The ability to perform less invasive procedures often allows more efficient, less painful, and more cost-effective patient care. The trend toward the diagnosis of tumors on the basis of small tissue samples will be discussed. The role of arterial embolization of highly vascular tumors such as giant-cell tumor, multiple myeloma, and metastatic renal-cell carcinoma will be reviewed. Radiofrequency ablation has become the standard treatment for patients with osteoid osteoma, but this technique is being expanded to assist in the palliative treatment of patients with painful bone metastasis. Finally, minimally invasive techniques such as kyphoplasty, vertebroplasty, and acetabuloplasty may provide an alternative to major reconstructive surgery for patients with metastatic disease.

Needle Biopsy

The original method of obtaining a histologic diagnosis of a bone or soft-tissue tumor was open incisional biopsy. For most pathologists, this method remains the so-called gold standard for making a diagnosis because it provides the best chance of obtaining representative tissue. However, the trend at many major musculoskeletal tumor centers over the past ten to fifteen years has been to use smaller amounts of tissue for diagnosis. The benefits of needle biopsy include cost efficiency, patient convenience, and avoidance of the problems associated with poor open biopsy techniques. Smaller, more specialized biopsy tools have been developed, leading to an 85% to 90% rate of accuracy1. Conscious sedation of the patient allows …

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