What Is a Bone Lesion Biopsy?

A bone lesion biopsy is a surgical procedure in which a doctor removes a sample of your bone tissue and sends it to a laboratory for testing. The test typically distinguishes between cancerous and noncancerous bone tumors and diagnoses other bone abnormalities.

The procedure involves making a small incision, drilling into the bone, and removing a sample of tissue from the lesion inside the bone. A lesion is an abnormality in the structure of the bone, which may or may not impact bone growth. Not all lesions are cancerous.

Your doctor may order a bone lesion biopsy if there are signs of abnormalities in your bones. These may show up on imaging scans, such as X-rays or CT scans. A biopsy helps doctors determine if your bone lesions are the result of cancer, infection, or another condition.

Conditions associated with bone tumors or lesions include:

  • coccidiomycosis (fungal infection)
  • Ewing’s sarcoma (cancerous bone tumor that affects children)
  • fibroma (benign tumor)
  • histoplasmosis (fungal infection)
  • multiple myeloma (cancer of the bone marrow involving plasma cells)
  • mycobacteria infection (tuberculosis)
  • osteoblastoma (benign bone tumor)
  • osteoid osteoma (benign bone tumor)
  • osteomalacia (softening of the bones due to a lack of vitamin D)
  • osteomyelitis (bone infection)
  • osteosarcoma (cancerous bone tumor that usually appears during adolescence)
  • osteitis fibrosa (softening of the bones due to hyperparathyroidism)
  • rickets (weakening of the bones due to lack of calcium, vitamin D, or phosphate)

Bone lesion biopsies can also provide surgeons with an inside view of your bones. This is helpful when inspecting the status of infections or diseases that could be candidates for amputation, such as osteomyelitis. In some cases, the biopsy can help prevent the need for an amputation.

Prior to your surgery, you’ll have imaging tests to determine the location of your bone lesions. Using these images, your surgeon will select the area from which they will take a tissue sample.

You’ll also undergo a physical examination. This is a good time to tell your doctor about any medications you’re taking, including over-the-counter medicines or supplements, and any allergies you may have.

You’ll most likely have to fast for eight hours before your biopsy. This is standard procedure, especially if you’re undergoing general anesthesia.

The location and type of biopsy will determine the type of anesthesia you need. You may have local, site-specific anesthesia, or you may need general anesthesia. Under general anesthesia, you’ll be in a painless sleep during the entire biopsy.

During the procedure, your surgeon will make a small incision in your skin above the bone where the sample will come from. What happens next depends on the type of biopsy you are having.

In a needle biopsy, your surgeon will drill a small hole into the bone. Your surgeon will extract a tissue sample using an instrument similar to a needle.

In an incisional biopsy, the surgeon will cut directly into the tumor to remove a sample. This type of biopsy can retrieve a larger tissue sample.

After removing the sample, your doctor will stitch the incision wound closed and bandage it. They’ll then send the tissue sample to a laboratory for testing.

All surgical procedures carry risks of infection and bleeding, which are greater for people with bleeding disorders or a compromised immune system. Tell your doctor if you have either of these risk factors.

Other possible complications specific to bone lesion biopsies include:

  • damage to surrounding tissue
  • excessive bleeding
  • bone fractures
  • infection of the bone or near the biopsy area

The risks of this test are significantly lower than the risk of not testing your bone lesions. Testing can help detect cancers or other serious health problems so that treatment can begin as quickly as possible.

After the biopsy, you’ll rest in a hospital bed until your doctor says you can go home. You will be in charge of taking care of your incision wound, which includes keeping the area clean and changing your bandages. Your doctor will remove your stitches at a follow-up appointment. The site of the biopsy may be sore for a few days after the procedure.

Your doctor will go over the results of your biopsy at a follow-up appointment. They’ll tell you the results of the bone biopsy and outline a treatment program.