Role of tru-cut biopsy in the management of myometrial lesions

Abstract

The aim of this article was to summarize current knowledge regarding ultrasound-guided tru-cut biopsy, with a focus on its applicability in preoperative diagnosis of myometrial lesions. Tru-cut biopsy is used in gynecologic oncology for the management of pelvic and abdominal tumors; however, its application in the diagnostic algorithm for uterine tumors has been validated by only a limited number of studies. Nevertheless, this literature review highlights that tru-cut biopsy of uterine smooth muscle lesions demonstrates high sample adequacy for histological examination, diagnostic accuracy, and a low complication rate. Leiomyomas are among the most common benign uterine tumors, whereas uterine sarcomas are rare and aggressive malignancies. Symptoms of these conditions do not differ significantly. Their differentiation relies on imaging methods such as ultrasonography and magnetic resonance imaging. However, distinguishing between benign and malignant tumors remains challenging, as criteria for differentiating benign and malignant lesions using these imaging methods have not yet been sufficiently validated. Incorporating tru-cut biopsy into the standard diagnostic algorithm for uterine tumors could provide valuable insights into the oncological nature of atypical tumors on ultrasonography or magnetic resonance imaging, leading to optimized and personalized treatment strategies for each patient.