In a potentially malignant mass, histological characterization or proof is required in almost all instances prior to deciding on specific therapy (immediate or secondary tu mor excision after initial chemotherapy). In lymphoma or leukemia, surgery is usually not indicated. Transcutaneous biopsy under direct vision by US or controlled by CT is a well established procedure in children, and should be performed under general anesthetic. CT is recommended as a safe alternative if direct guidance by US is difficult to achieve or is unsafe because of the small size or problematic location of the target lesion (e.g., a paravertebral process).
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