[Telecommunication and telepathology in orthopedic oncology. Possibilities in diagnosis and therapy of primary malignant bone tumors].

The rareness of primary malignant bone tumors and the difficulty of differential diagnosis make this field a part of oncology in which the consulting physician must rely on consistent histopathological monitoring of highest quality throughout the diagnostic and therapeutic process. In a pilot project of the Department of Bone Pathology of the University of Hamburg and the Orthopedic Department of the University of Heidelberg, 190 cases of suspected primary bone tumor were the subject of interdisciplinary discussion between July 2001 and March 2003 using a telepathology system established for this purpose. Diligent differential diagnoses were made prior to the biopsy; optimal location and further strategy for the biopsy were discussed and determined according to the guidelines of the international bone tumor centers. This also included the decision if intraoperative pathological examination of frozen sections should be performed. In 51 cases such examinations were performed. Those results immediately influenced the surgical procedure. Telepathology performed as described in this article led to a close interdisciplinary cooperation over a large distance and helped significantly to optimize therapy of patients with malignant bone tumors.