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Figure 1. Suboptimal biopsy of Ewing sarcoma in the distal right femur in a 36-year-old man. CT scan obtained during core needle biopsy performed at an outside institution without orthopedic oncologic surgical consultation reveals that the needle was incorrectly inserted using an anterior approach through the rectus femoris muscle. LSS was performed using the standard lateral approach, but the surgeon was forced to perform an additional resection of the anterior portion of the biopsy track. Postoperative knee extension was compromised. Despite the administration of preoperative radiation therapy and chemotherapy and clean surgical margins, the tumor recurred adjacent to the resected biopsy track 9 months later.
