
Instances in which sarcomas were seeded along needle biopsy tracks are easier to document as iatrogenic  [doctor-caused] because the tumors are obviously growing in an artificial path. 

Viable tumour spread in FNA biopsy tracks has been histologically confirmed.  Although this complication is not common and is of unknown clinical significance, it is one that all clinicians who undertake FNA of malignant neoplasms should be aware of. [24]   There are documented instances in which sarcomas were seeded along needle biopsy tracks.  [4, 6, 7]  At least one cancer so frequently implants along the needle track that fine needle biopsies of its suspected lesions are no longer routinely recommended. [8] It is also possible to track and implant tumor deposits with other devices than needles, including gastrostomy tubes, stereotactic cannulas, and postoperative drains. [10, 17, 18, 22, 23]   Implantation also can occur after percutaneous ethanol injection into the tumors [25] and thoracoscopic or laparoscopic or other surgical intervention. [29]

"The incidence of implantation metastases after fine-needle procedures is probably underestimated. There is a slight but definite risk that the procedure may render an otherwise curative resection palliative. Implantation metastases cause local complaints of varying severity and seem to have a tendency to recur locally. We recommend that fine-needle biopsy should be restricted to patients who will truly benefit from a more accurate preoperative diagnosis."  [20]

"Two cases are reported in which percutaneous biopsy of resectable liver tumours was performed unnecessarily and resulted in needle track seeding. In both instances patients who underwent potentially curative liver resection were rendered incurable because of biopsy track recurrence. The common practice of performing percutaneous ultrasound or CT guided biopsy of potentially resectable lesions in the liver is generally neither necessary nor desirable." [21]

The risk of implantation metastases induced by fine-needle biopsy warrants consideration in patients with abdominal malignancies since it may compromise the outcome of radical surgery. It should only be performed when the result of the procedure has a direct impact on the choice of therapy. [30]

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