Ultrasound-guided intracavitary biopsy diagnoses pelvic masses in 12 cases. (Patients with Prior Malignancies).

ASHLAND, ORE.--Ultrasound-guided intracavitary biopsies of pelvic masses can be safely and accurately performed in patients with a prior diagnosis of cancer who cannot or will not undergo a surgical biopsy Dr. Fikret Atamdede reported.

Dr. Atamdede reviewed 12 cases of women with prior nonovarian malignancies found to have a new pelvic mass on physical examination and/or imaging studies. The majority were severely medically compromised, suffering from severe pulmonary disease, cardiac failure, morbid obesity, or malnutrition, making them poor surgical candidates. One patient who was considered a good surgical candidate refused surgery despite extensive counseling, he said at the annual meeting of the Pacific Coast Obstetrical and Gynecological Society.

Importantly all of the patients were potential candidates for chemotherapy or radiation therapy if their masses proved to be malignant.

Serial imaging studies would have provided guidance about whether the masses were malignant, but also would have contributed to a delay in therapeutic intervention.

In addition, "one cannot discount in any way the psychological impact of delay in someone who has already had a devastating or life-threatening diagnosis once in their life," said the gynecologic oncologist, who conducted the retrospective descriptive study along with colleagues in radiology and pathology at the Harbor-UCLA Medical Center in Torrance, Calif.

Transvaginal or transrectal biopsies were planned, depending on the location of the tumor and the condition of each patient. For example, one of two patients who underwent a transrectal biopsy had undergone extensive radiation therapy that made transvaginal ultrasound impossible. The other had a tumor more easily accessible from a transrectal approach.

The patients were aged 46-76 and had prior histories of breast, endometrial, colon, ...