Accuracy Of Percutaneous Core Biopsy In Management Of Small Renal Masses

Main Category: Urology / Nephrology
Also Included In: Cancer / Oncology
Article Date: 04 Apr 2009 - 4:00 PDT

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UroToday.com - The advent of nephron sparing surgery for small localized renal tumors has been spurred by the recognition of the importance of long-term preservation of renal function - especially in patients with a propensity for renal insufficiency due to hypertension, diabetes and aging.

The number of small, < 4 cm, renal tumors found incidentally is increasing and the literature indicates upward of 20 to 30% of these lesions are benign. This study from the University of Michigan suggests that renal biopsy may be an important part of the decision-making process for treatment of small renal masses. Even though 9% of the 110 percutaneous renal biopsies of small renal masses were indeterminate, the biopsies that revealed malignancies had a 100% concordance with the final pathologic diagnosis from the extirpative surgical tissue. These researchers similarly found that 35% of the biopsy lesions were benign. There were very few complications and none were major. There were 7 biopsies that revealed oncocytoma and none of them demonstrated radiographic growth over a median follow-up of 0.55 years.

Therefore, it would seem that renal tumor biopsy should be considered in the algorithm of choosing the best treatment especially in patients at risk for developing chronic renal insufficiency.

Wang R, Wolf JS Jr, Wood DP Jr, Higgins EJ, Hafez KS

Urology. 2009 Mar;73(3):586-90
10.1016/j.urology.2008.08.519

Written by UroToday.com Contributing Editor Elspeth M. McDougall, MD, FRCSC, MHPE

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