Useless and dangerous--fine needle aspiration of hepatic colorectal metastases

doi:10.1136/bmj.328.7438.507

BMJ 2004;328:507-508 (28 February), doi:10.1136/bmj.328.7438.507

Clinical review

Lesson of the week

Useless and dangerous—fine needle aspiration of hepatic colorectal metastases

M S Metcalfe, visiting surgeon¹, F H G Bridgewater, consultant surgeon¹, E J Mullin, research registrar¹, G J Maddern, professor of surgery¹

¹ University of Adelaide Department of Surgery, Queen Elizabeth Hospital, Woodville, SA 5011, Australia

Correspondence to: G J Maddern guy.maddern@adelaide.edu.au

The first 150 words of the full text of this article appear below.

Introduction

Fine needle aspiration cytology (FNAC) is an established toolfor diagnosing liver tumours. It has recognised complications,however. Use of the procedure in abdominal tumours is fatalin 0.006 to 0.031% of cases.^1
2 Most deaths occur with livertumours and are due to haemorrhage. Another complication isthat metastases can seed along biopsy needle tracts, althoughthis has been reported to be rare, with an incidence of 0.003%to 0.07%, mostly from pancreatic tumours.^1
2 More recently,much higher rates (0.4% to 5.1%) of needle tract metastaseshave been reported when FNAC is used in liver lesions, usuallyfor primary liver tumours.^3-7

Only 13 cases of needle tract colorectal metastases caused byFNAC in liver lesions are described in journals listed in Medline.^7-13Several authors have commented that the procedure should beavoided because of the risk of this complication. A furthersimilar case is reported here, extending the contraindicationof . . . [Full text of this article]

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Rapid Responses:

Read all Rapid Responses

FNAC Not useless. Less invasive but with a risk!: Fraser M Brown
bmj.com, 28 Feb 2004 [Full text]
The place of fine needle aspiration: �lvaro Sanz, et al.
bmj.com, 28 Feb 2004 [Full text]
BMJ enters the arena of tabloid journalism: Anton E Joseph
bmj.com, 29 Feb 2004 [Full text]
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bmj.com, 1 Mar 2004 [Full text]
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Useless and dangerous statement about FNAC from liver metastasis from colo-rectal cancer: Bjorn Skjoldbye, et al.
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Some "anecdotal" thoughts.: Hilary Butler
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