This 59-years old lady came with a breast lump, which on biopsy turned out to be carcinoma.
Her PET/CT showed a solitary osteolytic lesion in the left frontal bone. There were no nodes and no other abnormality.
The surgeon wanted a biopsy of the left frontal lesion. I told him that this is normally done by a neurosurgeon. His question was…but can you do it anyway? There was no technical difficulty and so no reason not to. I placed the patient in the right lateral decubitus position with the left frontal bone facing upwards and obliquely did the biopsy with an 18G coaxial biopsy gun.
The diagnosis was metastasis from carcinoma breast.
This is not difficult. An osteolytic lesion anywhere else in the body like this would be a simple procedure. The issue is of getting over the mindset of whose domain this is or not.