Contemporary Results of Percutaneous Biopsy of 100 Small Renal Masses: A Single Center Experience

No AccessJournal of UrologyAdult Urology1 Dec 2008Contemporary Results of Percutaneous Biopsy of 100 Small Renal Masses: A Single Center Experience Alessandro Volpe, Kamal Mattar, Antonio Finelli, John R. Kachura, Andrew J. Evans, William R. Geddie, and Michael A.S. Jewett Alessandro VolpeAlessandro Volpe , Kamal MattarKamal Mattar , Antonio FinelliAntonio Finelli , John R. KachuraJohn R. Kachura , Andrew J. EvansAndrew J. Evans , William R. GeddieWilliam R. Geddie , and Michael A.S. JewettMichael A.S. Jewett View All Author Informationhttps://doi.org/10.1016/j.juro.2008.08.014AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Percutaneous biopsy of small renal tumors has not been historically performed because of concern about complications and accuracy. We reviewed our experience with percutaneous needle biopsy of small renal masses to assess the safety and accuracy of the procedure, the potential predictors of a diagnostic result and the role of biopsy in clinical decision making. Materials and Methods: A total of 100 percutaneous needle biopsies of renal masses less than 4 cm were performed between January 2000 and May 2007 with 18 gauge needles and a coaxial technique under ultrasound and/or computerized tomography guidance. A retrospective chart review was performed to document the complication rate and the ability to obtain sufficient tissue for diagnosis. Tumor size, tumor type (solid vs cystic), image guidance, biopsy number and core length were assessed for the ability to predict a diagnostic biopsy. Results: No tumor seeding or significant bleeding was observed. Of the core biopsies 84 (84%) were diagnostic for a malignant (66) or a benign (18) tumor. Larger tumor size and a solid pattern were significant predictors of a diagnostic result. Histological subtyping and grading were possible on core biopsies in 93% and 68% of renal cell carcinomas, respectively. A total of 20 patients underwent surgery after a diagnostic biopsy. The histological concordance of biopsies and surgical specimens was 100%. Conclusions: Percutaneous needle biopsy of renal masses less than 4 cm is safe and provides adequate tissue for diagnosis in most cases. Larger tumor size and a solid pattern are significant predictors of a successful biopsy. Renal tumor biopsy decreases the rate of unnecessary surgery for benign tumors and can assist the clinician with treatment decision making, especially in elderly and unfit patients. References 1 : Rising incidence of renal cell cancer in the United States. JAMA1999; 281: 1628. Google Scholar 2 : Prospective evaluation of fine needle aspiration of small, solid renal masses: accuracy and morbidity. Urology1997; 50: 25. 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Google Scholar Departments of Surgical Oncology (Division of Urology) (AV, KM, AF, MASJ), Medical Imaging (JRK) and Pathology (AJE), Princess Margaret Hospital and University Health Network, University of Toronto, Toronto, Ontario, Canada© 2008 by American Urological AssociationFiguresReferencesRelatedDetailsCited byCate F, Kapp M, Arnold S, Gellert L, Hameed O, Clark P, Wile G, Coogan A and Giannico G (2018) Core Needle Biopsy and Fine Needle Aspiration Alone or in Combination: Diagnostic Accuracy and Impact on Management of Renal MassesJournal of Urology, VOL. 197, NO. 6, (1396-1402), Online publication date: 1-Jun-2017.Laguna M (2018) Re: Management of Small Renal Masses: American Society of Clinical Oncology Clinical Practice GuidelineJournal of Urology, VOL. 198, NO. 3, (480-482), Online publication date: 1-Sep-2017.Jeon H, Seo S, Jeong B, Jeon S, Lee H, Choi H, Song C, Hong J, Kim C, Ahn H and Jeong I (2018) Percutaneous Kidney Biopsy for a Small Renal Mass: A Critical Appraisal of ResultsJournal of Urology, VOL. 195, NO. 3, (568-573), Online publication date: 1-Mar-2016.Patel H, Johnson M, Pierorazio P, Sozio S, Sharma R, Iyoha E, Bass E and Allaf M (2016) Diagnostic Accuracy and Risks of Biopsy in the Diagnosis of a Renal Mass Suspicious for Localized Renal Cell Carcinoma: Systematic Review of the LiteratureJournal of Urology, VOL. 195, NO. 5, (1340-1347), Online publication date: 1-May-2016.Donat S, Diaz M, Bishoff J, Coleman J, Dahm P, Derweesh I, Herrell S, Hilton S, Jonasch E, Lin D, Reuter V and Chang S (2018) Follow-up for Clinically Localized Renal Neoplasms: AUA GuidelineJournal of Urology, VOL. 190, NO. 2, (407-416), Online publication date: 1-Aug-2013.Millet I, Curros F, Serre I, Taourel P and Thuret R (2018) Can Renal Biopsy Accurately Predict Histological Subtype and Fuhrman Grade of Renal Cell Carcinoma?Journal of Urology, VOL. 188, NO. 5, (1690-1694), Online publication date: 1-Nov-2012.Breau R, Crispen P, Jenkins S, Blute M and Leibovich B (2018) Treatment of Patients With Small Renal Masses: A Survey of the American Urological AssociationJournal of Urology, VOL. 185, NO. 2, (407-414), Online publication date: 1-Feb-2011.Kawaguchi S, Fernandes K, Finelli A, Robinette M, Fleshner N and Jewett M (2018) Most Renal Oncocytomas Appear to Grow: Observations of Tumor Kinetics With Active SurveillanceJournal of Urology, VOL. 186, NO. 4, (1218-1222), Online publication date: 1-Oct-2011.Skolarus T, Serrano M, Grubb R, Katz M, Bullock T, Gao F, Humphrey P and Kibel A (2018) Effect of Reclassification on the Incidence of Benign and Malignant Renal TumorsJournal of Urology, VOL. 183, NO. 2, (455-459), Online publication date: 1-Feb-2010. Volume 180Issue 6December 2008Page: 2333-2337 Advertisement Copyright & Permissions© 2008 by American Urological AssociationKeywordsbiopsyrenal cellbiopsykidneycarcinomafine needlediagnosisMetricsAuthor Information Alessandro Volpe More articles by this author Kamal Mattar More articles by this author Antonio Finelli More articles by this author John R. Kachura More articles by this author Andrew J. Evans More articles by this author William R. Geddie More articles by this author Michael A.S. Jewett More articles by this author Expand All Advertisement PDF downloadLoading ...