ABSTRACT

Renal tumor biopsies gained popularity in the evaluation of small renal tumors because imaging alone is not sufficient to show the underlying aggressiveness of small renal tumors. And also ablative therapies without definitive histology are available. There have been recent advances in imaging, interventional, and cytologic techniques that have increased the role of percutaneous biopsy in the diagnosis of renal masses. Biopsy results are used to confirm the diagnosis of renal cancers, metastases and infections. There is increasing evidence to suggest that biopsy can help subtype and grade many primary renal cancers. Because a considerable fraction of small solid renal masses are benign and do not need treatment, there is an increasing need to diagnose them. Biopsy after a full imaging work-up can help prevent unnecessary and potentially morbid surgical and ablation procedures in a substantial number of patients. Major complications such as serious bleeding or pneumothorax are rare. Tumor seeding which is the most feared complication of the procedure is not seen in recent years. Renal tumor biopsy can help patient management by finding benign renal tumors. Future clinical algorithms will likely incorporate renal biopsies in cases in which decision making is so hard.