Complications of a disposable biopsy in a distinctive, inoperable malignant cystic tumor - a case discussion

Unclear distinctive neoplasm in the head and neck area often require histology in clinical routine for diagnosis assurance and treatment planning. While open biopsy procedures are invasive and often require general anaesthesia, the minimally invasive fine needle aspiration cytology is associated with a certain rate of false-negative or uncertain outcome. The disposable biopsy is a minimally invasive method that promises high diagnostic reliability with a low complication rate.

A 65-year-old female patient presented with a size-proportional lesion cervical right, which had been present for 4 weeks. Beside moderate dysphasia, the patient did not complain of any other symptoms. The imaging of the neck (ultrasound, MRI) showed a distinctive partial cystic lesion cervical right 8x7cm as well as a smaller cystic findings of the thyroid gland on the left. A few hours after the biopsy, acute tension pneumothorax was appeared and treated interdisciplinary with intensive care. The histological findings of the right side of neck revealed a poorly differentiated, non-keratinizing, partially necrotic squamous cell carcinoma (G3). A subsequent panendoscopy revealed a small hypopharyngeal carcinoma as the primary.

In terms of differential diagnosis, such a lesion must be considered in addition to the possible benign cystic changes primarily as a malignant tumor. Ultrasound-assisted biopsy is an option for histological confirmation. However despite the rare complications of biopsy in the case of extensive lesions can lead to difficult situations that have an influence on the possible treatment options. Through a committed, interdisciplinary approach, the complications can be detected early and treated adequately.

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Publication History

Article published online:
10 June 2020