CT guided transgluteal biopsy

Case contributed by Dr Ian Bickle

Presentation

Previous surgery for rectal cancer. Rising CEA. Follow up CT suggested pelvic recurrence.

Patient Data

Age: 55
Gender: Male
CT

Rectal anastomosis.

2cm nodule of soft tissue along the right posterior pelvic sidewall, adjacent to the anastomosis.

CT

The various steps of the process of trans-gluteal biopsy acquisition.

This includes the initial local anaesthesia infiltration and re-angulation prior to establishment of the optimal biopsy track.

The last images is the prone final co-axial needle position images flipped to supine to aid visualisation relative to the initial planning CT.

Photo

Biopsy result confirming radiological suspicion of recurrent tumour.

Case Discussion

Transgluteal biopsy and drainage is one of the least common routes undertaken in image guided biopsy.   It virtually always requires CT for image guidance.

Good anaesthesia is important to ascertain patient cooperation at the tract crosses the large sensitive gluteal muscles.

It is typically uses for accessing pelvic tumours or recurrence for biopsy and the drainage of colorectal or gynaecological related collections. 

In this case the nodule of presume local recurrence was accessed for biopsy to guide ongoing oncological management.

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Case information

rID: 48276
Case created: 28th Sep 2016
Last edited: 4th Oct 2016
Inclusion in quiz mode: Excluded

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