Sarcoma 
Volume 5 (2001), Issue 2, Pages 89-94
doi:10.1155/S1357714X01000172

Diagnosing Musculoskeletal Tumours

Robert J. Grimer,1,2 Simon R. Carter,1 David Spooner,1 and Rodney S. Sneath1

 1The Royal Orthopaedic Hospital Oncology Service, Birmingham, UK
2The Royal Orthopaedic Hospital Oncology Service, The Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham B31 2AP, UK

Abstract

In 1993 we became aware of a worrying increase in apparent errors in the histopathological diagnosis of musculoskeletal tumours in our Unit. As a result all cases seen over the past 8 years were reviewed by an independent panel. Of the 1996 cases reviewed there was an error in 87. In 54 cases (2.7%) this had led to some significant change in the active management of the patient. The main areas where errors arose were in those very cases where clinical and radiological features were not helpful in confirming or refuting the diagnosis. The incidence of errors rose with the passage of time, possibly related to a deterioration in the pathologist’s health. The error rate in diagnosing bone tumours in previously published series ranges from 9 to 40%. To ensure as accurate a rate of diagnosis as possible multidisciplinary working and regular audit are essential.