Ultrasound guided biopsy of rib metastasis

Case contributed by Ian Bickle


CT suggests metastatic lung cancer, Request for liver biopsy for histology.

Patient Data

Age: 70 years
Gender: Male

3.5cm expansile rib metastasis with cortical breech.

16G core biopsy undertaken.

Radiologist suggests to the clinician a safer, easier method of tissue diagnosis would be from an ultrasound-guided rib biopsy.

This could be done as an outpatient rather than requiring admission for post-procedural monitoring. 

Case Discussion

A few learning points here.

1.  Even if asked to biopsy a specific site, review the prior imaging to see if an easier, safer more convenient site if available as an alternative.

2.  If a bone metastasis has a soft tissue component a standard biopsy needle can be used (no need for a bone biopsy needle).

3.  Deeper 'subcutaneous' masses are often easier to biopsy with the curvilinear probe than a linear probe, although initially counterintuitive (see different in diagnosis images here and the biopsy throw image)

4. A biopsy without admission is nearly always more popular with the patient and cheaper for the healthcare system.  But only do if safe to do so. Safety must come first.

Histology:   Metastasis from a hepatocellular carcinoma

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.