Broken Trephine Biopsy Needle: A Case Report of a Rare but Not Impossible Complication

Abstract

Background: Bone marrow aspiration and trephine biopsy are essential procedures in haematology  for the diagnosis, prognostication, and monitoring of a wide range of haematological disorders. Although generally safe, rare procedural complications may occur, including breakage of the biopsy needle. Case Presentation: We report the case of a 67-year-old man with recurrent transfusion-dependent anaemia and neutropenia who underwent bone marrow aspiration and trephine biopsy as part of his diagnostic evaluation. During the trephine biopsy procedure, the biopsy needle fractured while being manipulated for core retrieval, leaving an approximately 3 cm fragment lodged within the posterior ilium. Radiographic imaging confirmed the retained fragment. Following multidisciplinary assessment, the patient underwent successful surgical extraction of the needle fragment by orthopaedic surgeons under local anaesthesia with monitored anaesthetic care. The postoperative course was uneventful, and the patient was discharged with appropriate follow-up. Discussion: Needle fracture during bone marrow biopsy is an exceptionally uncommon complication, with only a limited number of cases reported in the literature. Factors that may contribute to its occurrence include patient movement, inadequate analgesia or sedation, operator-related technical challenges, and compromised needle integrity. Prompt recognition, radiological localisation, and multidisciplinary management are essential to minimise morbidity. Conclusion: Broken trephine biopsy needles represent a rare but significant complication of bone marrow biopsy procedures. Awareness of this possibility, careful procedural technique, adequate patient comfort measures, and assessment of equipment integrity are important for prevention. Reporting such cases contributes to improved recognition and management of this unusual event.