ABSTRACT
These guidelines are based on protocol MMT-98 of the Sociéte Internationale D’Oncologie Pédiatrique, Zurich, Switzerland.
The biopsy should be performed by or in consultation with the surgeon responsible for the ultimate management of the patient. An inappropriately sited biopsy incision may make a subsequent complete resection impossible and compromise the outcome. Methods of biopsy, other than excision, include direct or endoscopic biopsy for superficial tumors, such as vaginal or bladder botryoid tumors, needle biopsy for prostatic and other accessible tumors, or incisional biopsy. The most direct approach to the tumor should be used, placing the needle puncture site or incision so that, where possible, it can be included in the skin incision at subsequent definitive resection (Fig. 78.1). Incisional biopsy is restricted to obtaining sufficient tissue for diagnostic purposes; tissue planes should not be dissected unnecessarily and tumor spillage must be kept to a minimum. The tissue layers are then accurately repaired. An excisional biopsy is preferred if the lesion is small and can be removed with an adequate margin of normal tissue. Tissue should always be submitted fresh, if possible. The pathologist should be alerted prior to the operation so that resected tissues can be collected and immediately processed. If fixative has to be used, it should be formalin based.
