Needle tract seeding of thyroid cancer after biopsy of distant metastasis: a retrospective cohort.

Endocrine-related cancer Pub Date : 2025-01-17 Print Date: 2025-03-01 DOI:10.1530/ERC-24-0263
Dana Hamadi, John J Schmitz, Chris N Gu, Hillary W Garner, Anil N Kurup, Marius N Stan
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Abstract

Imaging-guided percutaneous core needle biopsy is currently the most common technique for the investigation of potentially malignant bone lesions. It allows precise needle placement and better visual guidance, leading to improved diagnostic accuracy. Needle tract seeding (NTS) is a rare complication of biopsies in general, and its true incidence remains unknown. This study aimed to assess the risk of NTS in patients with thyroid cancer who underwent bone biopsy. For our cohort, we extracted data from the electronic medical record at the Mayo Clinic in Rochester (Minnesota, USA). Inclusion criteria included patients with a history of thyroid cancer who underwent biopsy for bone metastasis between 1/1/2014 and 10/1/2023. We identified a cohort of 20 patients that fit our inclusion criteria. Of these 20 patients, 2 patients developed NTS after CT-guided bone biopsy. Cases of seeding had a larger tumor size, a more aggressive histopathological presentation, a significantly shorter duration between cancer diagnosis and bone metastasis, and underwent more tumor manipulation procedures, such as biopsy and radiofrequency ablation, in contrast to those without seeding. In conclusion, our study identified NTS to have an incidence of 10% after biopsies of bone metastasis related to thyroid carcinoma. These are likely the result of an interplay of risk factors, including tumor biology, penetrated tissues and procedural technical details. Further studies with larger sample sizes are needed to confirm our findings and identify strategies to mitigate NTS.

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甲状腺癌远处转移活检后的针道播种:一个回顾性队列。
成像引导下经皮穿刺活检(PCNB)是目前最常用的技术,用于调查潜在的恶性骨病变。它允许精确的针头放置和更好的视觉引导,从而提高诊断的准确性。针道播种(NTS)通常是活检的罕见并发症,其真正的发病率尚不清楚。本研究旨在评估接受骨活检的甲状腺癌患者发生NTS的风险。对于我们的队列,我们从明尼苏达州罗切斯特市梅奥诊所的电子病历(EMR)中提取数据。纳入标准为2014年1月1日至2023年10月1日期间有甲状腺癌病史并行骨转移活检的患者。我们确定了符合纳入标准的20例患者。在这20例患者中,2例患者在ct引导下骨活检后发生NTS。与没有播种的病例相比,播种的病例肿瘤体积更大,组织病理学表现更积极,从癌症诊断到骨转移的时间明显更短,并且接受了更多的肿瘤操作程序,如活检和RFA。总之,我们的研究确定NTS在甲状腺癌相关骨转移活检后的发生率为10%。这些可能是风险因素相互作用的结果,包括肿瘤生物学、穿透组织和手术技术细节。需要更大样本量的进一步研究来证实我们的发现并确定减轻NTS的策略。
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