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Pain management
1%
20/2915
Hanging arm sling
3%
97/2915
Tumor staging, including bone scan, CT of chest, MRI of the entire bone
4%
118/2915
Consultation with pediatric oncology
28/2915
Tumor biopsy performed by interventional radiology
90%
2634/2915
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Tumor biopsy, even if performed by interventional radiology, can contaminate the future resection of this malignant appearing proximal humeral lesion, making limb salvage not possible. Pain control, splinting, staging/consultation with pediatric oncology will not negatively affect this child's oncologic outcome in the way that an inappropriate biopsy can. The referenced article by Mankin et al. summarizes the efforts of the 1982 Musculoskeletal Tumor Society's (MSTS) review of biopsies performed either by surgeons or at facilities not accustomed to treating bone and soft tissue tumors. Errors, complications, and changes in the course and outcome were two to twelve times greater (p < 0.001) when the biopsy was done in a referring institution instead of in a treatment center. As such, it is the stance of the MSTS that the biopsy should be performed under the direction of the treating surgeon.
3.6
(24)
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