Abstract
Cross-sectional imaging shows a limited diagnostic accuracy for the histological discrimination of small renal masses (SRM). In this scenario, a renal tumor biopsy is a safe, feasible and effective diagnostic tool that can guide treatment strategy by providing the histological characterization of a SRM. Although nephron-sparing surgery is still considered the gold standard treatment for patients with SRM, more and more evidence suggests that active surveillance (AS) is a reasonable alternative option, especially in old and comorbid patients. Indeed, owing to the relatively slow growth and favorable biology of SRM, AS followed up by, if necessary, a delayed intervention provides an optimal oncological outcome with low rates of systemic progression or death.
Highlights
Kidney cancer is one of the few tumors that is only treated if there is a radiological probability of malignancy
A percutaneous renal tumor biopsy (RTB) has emerged as a promising diagnostic tool that may help in the clinical decision-making process by distinguishing benign from malignant radiological inconclusive renal lesions, and may be considered suitable for patients who are candidates for either active surveillance or nephron-sparing treatments[1,2,3]
Tissue sampling can be realized with fine needle aspiration (FNA) and/or core biopsy (CB)[1,4]
Summary
Kidney cancer is one of the few tumors that is only treated if there is a radiological probability of malignancy. This concern is related to the limited diagnostic accuracy of computed tomography and magnetic resonance imaging in the histologic characterization of small renal masses (SRM)[1]. A percutaneous renal tumor biopsy (RTB) has emerged as a promising diagnostic tool that may help in the clinical decision-making process by distinguishing benign from malignant radiological inconclusive renal lesions, and may be considered suitable for patients who are candidates for either active surveillance or nephron-sparing treatments[1,2,3].
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