Ultrasound-Guided Transvaginal Core Biopsy of Pelvic Masses: Feasibility, Safety, and Short-Term Follow-Up

OBJECTIVE. The purpose of this study was to evaluate the diagnostic accuracy and safety of ultrasound (US)-guided transvaginal core biopsy of pelvic masses. MATERIALS AND METHODS. Fifty-five pelvic masses in 55 consecutive women who underwent US-guided transvaginal core biopsy were enrolled in our study. All lesions were detected on CT or MRI before biopsy. The procedure was performed with local anesthesia using a transvaginal US probe equipped with a guide and an 18-gauge needle with an automatic biopsy gun. We evaluated the diagnostic accuracy and complication rate of the procedure. RESULTS. All acquired specimens were adequate for the histopathologic analysis. The overall diagnostic accuracy of US-guided transvaginal core biopsy was 93% (51/55). Of the 55 lesions, 46 (84%) were confirmed to be either benign or malignant tumors, and five (9%) were diagnosed as active or chronic inflammatory lesions. Four lesions (7%) were not histopathologically diagnosed after biopsy: two were confirmed as fibrothecoma and leiomyosarcoma after surgery, and the remaining two were clinically determined to be recurrent cancer. In terms of minor complications, vaginal bleeding occurred in 10 patients (18%), and gross hematuria occurred in two patients (4%). These complications resolved spontaneously in all patients without further workup or treatment. CONCLUSION. US-guided transvaginal core biopsy seems to be safe and reliable procedure for the histopathologic diagnosis of pelvic masses.