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Core Biopsy in Men with Peritoneal Carcinomatosis

Mountain Empire Radiology, Johnson City, TN 37601, e-mail: gispence@msn.com

Editor:

Dr Spencer and colleagues in the October 2001 issue of Radiology (1) demonstrated the efficacy of core biopsy in women with peritoneal carcinomatosis. Too many women with bowel or appendiceal primary sites undergo unnecessary oophorectomy and incomplete debulking procedures before the correct site of origin is identified. These surgical procedures delay and interfere with subsequent therapy, particularly complete surgical cytoreduction and intraperitoneal chemotherapy.

Men with peritoneal carcinomatosis would also benefit from needle biopsy instead of explorative surgery for the same reasons. There is no scarring or presence of adhesions to interfere with subsequent surgery. An experienced pathologist can often suggest possible sites of origin on the basis of core specimens.

If findings from core biopsy indicate mucinous adenocarcinoma or adenomucinosis, radiologists should carefully review computed tomographic (CT) scans for a possible primary appendiceal site, since this site is the most amenable to the aggressive therapies that are available in a few centers in the United States.

REFERENCES

1. Spencer JA, Swift SE, Wilkinson N, Boon AP, Lane G, Perren TJ. Peritoneal carcinomatosis: image-guided peritoneal core biopsy for tumor type and patient care. Radiology 2001; 221:173-177.[Abstract/Free Full Text]

Drs Spencer and Swift respond:

Department of Clinical Radiology, St James’s University Hospital, Beckett Street, Leeds LS9 7TF, England, e-mail: johnaspencer50@hotmail.com

We would like to thank Dr Spence for his interest in our work (1) and we agree, as we emphasized in the Discussion, that the technique has a far wider application in cancer care than that in the specific patient group we studied. The technique is simple and safe and when used after multidisciplinary case review can prevent unnecessary laparoscopy or nontherapeutic laparotomy by directing care on the basis of a firm histologic diagnosis.

Core biopsy is now a routine procedure in our cancer center, and further experience has confirmed the accuracy of immunohistochemical techniques in helping to identify primary cancer sites with poorly differentiated histologic findings.

All of our biopsy procedures followed diagnostic abdominal ultrasonography and CT and had been subject to careful multidisciplinary review. We agree that it is important to carefully examine all potential primary tumor sites within the examination volume.

REFERENCES

1. Spencer JA, Swift SE, Wilkinson N, Boon AP, Lane G, Perren TJ. Peritoneal carcinomatosis: image-guided peritoneal core biopsy for tumor type and patient care. Radiology 2001; 221:173-177.

This Article Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Spence, G. I. Articles by Swift, S. E. Search for Related Content PubMed PubMed Citation Articles by Spence, G. I. Articles by Swift, S. E.