Small renal mass biopsy – how, what and when: report from an international consensus panel
Article first published online: 17 JAN 2014
© 2013 The Authors. BJU International © 2013 BJU International
Volume 113, Issue 6, pages 854–863, June 2014
How to Cite
Tsivian, M., Rampersaud, E. N., del Pilar Laguna Pes, M., Joniau, S., Leveillee, R. J., Shingleton, W. B., Aron, M., Kim, C. Y., DeMarzo, A. M., Desai, M. M., Meler, J. D., Donovan, J. F., Klingler, H. C., Sopko, D. R., Madden, J. F., Marberger, M., Ferrandino, M. N. and Polascik, T. J. (2014), Small renal mass biopsy – how, what and when: report from an international consensus panel. BJU International, 113: 854–863. doi: 10.1111/bju.12470
- Issue published online: 6 JUN 2014
- Article first published online: 17 JAN 2014
- Accepted manuscript online: 14 OCT 2013 04:15AM EST
- small renal mass;
- renal cell carcinoma (RCC);
- renal mass biopsy;
- To discuss the use of renal mass biopsy (RMB) for small renal masses (SRMs), formulate technical aspects, outline potential pitfalls and provide recommendations for the practicing clinician.
- The meeting was conducted as an informal consensus process and no scoring system was used to measure the levels of agreement on the different topics.
- A moderated general discussion was used as the basis for consensus and arising issues were resolved at this point.
- A consensus was established and lack of agreement to topics or specific items was noted at this point.
- Recommended biopsy technique: at least two cores, sampling different tumour regions with ultrasonography being the preferred method of image guidance.
- Pathological interpretation: ‘non-diagnostic samples’ should refer to insufficient material, inconclusive and normal renal parenchyma. For non-diagnostic samples, a repeat biopsy is recommended. Fine-needle aspiration may provide additional information but cannot substitute for core biopsy.
- Indications for RMB: biopsy is recommended in most cases except in patients with imaging or clinical characteristics indicative of pathology (syndromes, imaging characteristics) and cases whereby conservative management is not contemplated. RMB is recommended for active surveillance but not for watchful-waiting candidates.
- We report the results of an international consensus meeting on the use of RMB for SRMs, defining the technique, pathological interpretation and indications.