LOSS OF EXPRESSION OF THE VITAMIN D RECEPTOR IN CLEAR CELL RENAL CELL CARCINOMA

Abstract

biopsy yielding 91 specimens. Three patients had 2 masses and three more patients underwent rebiopsy. A definitive diagnosis was established in 76 patients (89%). Of the 91 specimens 22 (24%) were benign including 11 oncocytomas, 7 lipid poor angiomyolipomas, 2 abscess/ pyelitis, 1 metanephric adenoma, and 1 benign spindle cell neoplasm. 20 patients (24%) had minor complications including 14 small perinephric hematomas (none required transfusion or admission to the inpatient ward), 2 difficulty voiding, 1 small pneumothorax, 1 rash, 1 shoulder pain, and 1 generalized musculoskeletal pain. The biopsy changed management in 22 patients (26%) with benign lesions or metastatic disease from another primary. Of the remaining 63 patients 24 underwent partial or radical nephrectomy. In all these patients the final pathology of these tumors confirmed the malignant diagnosis derived from biopsy. The remainder of the patients elected needle ablation or observation. CONCLUSIONS: CT guided biopsy of a small solid renal mass is a safe procedure that provides diagnostic information about 90% of the time. Biopsy provides clinically useful information by identification of benign lesions and confirmation of type and grade of malignancy if either resection of needle ablative therapy is a consideration.