Case 44: IVC Leiomyosarcoma Biopsy – The Tragedy of “It Can’t Be Done” and “Covid-19” and "Procrastination”

Region: Retroperitoneum
Age: 56
Findings: IVC mass
Lesion Biopsied: Large exophytic component
Size of Lesion: Huge
Gun: 18 G 20 mm throw
No of cores: 5 for HP
Sedation: No
Position & Approach: Supine, In-plane angulation
Time Taken (marker to wash-out): 8 mins
Complication: None
Level of Difficulty: 1/5
Diagnosis: IVC Leiomyosarcoma

This 56-years old came with an IVC mass for a biopsy. Her last scan was an MRI of March 2020, which I mistook for March 2021 and despite my rule that we need a scan that is not older than 4 weeks, I decided to go ahead with the biopsy assuming that at the most it would be stable or would have progressed.

As it turns out the scan was from March 2020 and they had procrastinated, partly because of Covid-19 and partly because they were told in a "big hospital" that "the biopsy can't be done and she will bleed to death".

Anyway, the video explains what happened and how it turned out be a simple 1/5 biopsy.

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