USE OF SONOSITE PORTABLE ULTRASOUND FOR PERI-OPERATIVE LOCALISATION OF IMPALPABLE TUMOURS

Objectives: It is common for breast surgeons to excise impalpable tumours and fine-wire localisation is commonly deployed by breast radiologists to facilitate such surgery. Pre-operative localisation can be achieved using conventional ultrasound but this necessitates co-ordination with the radiology department. Methods: We have utilised the SonoSite (SonoSite Inc, Bothell, WA) portable ultrasound system available widely in operating theatres for insertion of vascular lines and perineural catheters, for localisation of deep impalpable tumours. Results: Two patients who had undergone mid-forearm amputations for synovial sarcoma are presented. The first presented with axillary recurrence of his tumour. MRI scanning of his stump revealed two lesions suspicious of recurrence. Both were impalpable initially. The lesions were identified using the SonoSite and excision biopsy performed. Histologically the lesions were neuromata. The second patient had imaging in keeping with neuromata and again the Sonosite was utilised to detect the lesions and facilitate removal. Discussion: Sonosite portable ultrasound machines are readily available in the operating theatre and may be utilised to aid removal of tumours. They do not replace other imaging but can make surgery less traumatic in that smaller incisions may be used.