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ISSN 1806-3713
© 2016 Sociedade Brasileira de Pneumologia e Tisiologia
http://dx.doi.org/10.1590/S1806-37562016000000280
Tumor seeding along the needle track after
percutaneous lung biopsy
Leonardo Guedes Moreira Valle
1
, Rafael Dahmer Rocha
1
,
Guilherme Falleiros Mendes
1
, José Ernesto Succi
2
, Juliano Ribeiro de Andrade
1
1. Departamento de Radiologia Intervencionista, Hospital Israelita Albert Einstein, São Paulo (SP) Brasil.
2. Departamento de Cirurgia Torácica, Hospital Israelita Albert Einstein, Albert Einstein, São Paulo (SP) Brasil.
A 56-year-old male patient underwent percutaneous
biopsy of a nodule in the right lung apex (Figure 1A). The
tip of a 19-gauge coaxial needle was positioned in the
posterior chest wall (Figure 1B), and six samples of the
lesion were obtained with a 20-gauge core needle. The
pathological analysis revealed squamous cell carcinoma.
Using an anterior approach, we performed right upper
lobectomy with tumor-free margins. At 6 months of
follow-up, a positron emission tomography-CT scan of
the chest showed an
18
F- uorodeoxyglucose-avid soft
tissue mass (Figure 1C) in the T3-4 interspace, along
the biopsy tract, as well as bone erosion of the right
third rib posteriorly (Figure 1D), suggesting tumor
seeding. A subsequent CT scan of the chest, obtained
two months later, conrmed local disease progression.
We then performed en bloc resection with disease-free
pleural margins, and the pathological analysis conrmed
that tumor seeding had occurred.
Tumor seeding along the biopsy route is exceedingly
rare. Certain factors, such as the use of large-bore
cutting needles, increase the risk of such tumor cell
dissemination, that risk also being greater when the
tumor is an adenocarcinoma.
RECOMMENDED READING
Kim JH, Kim YT, Lim HK, Kim YH, Sung SW. Management for chest wall
implantation of non-small cell lung cancer after ne-needle aspiration
biopsy; Eur J Cardiothorac Surg. 2003;23(5):828-32. http://dx.doi.
org/10.1016/S1010-7940(03)00095-2
Figure 1. Nodule in the right lung apex and percutaneous biopsy of the same: in A, positron emission tomography-CT
(PET-CT) scan showing the nodule (arrow); in B, CT scan showing the point of insertion of the coaxial needle (arrow); in C,
PET-CT scan after 6 months of follow-up, showing an
18
F-uorodeoxyglucose-avid soft tissue mass; and in D, CT scan after
6 months of follow-up, showing bone erosion of the right third rib posteriorly (arrow).
A
C
B
D
J Bras Pneumol. 2016;42(1):71-71
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