[Value of percutaneous kidney biopsy in the management of solid renal tumours less or equal to 4 cm].
OBJECTIVE
To assess the value of diagnostic percutaneous kidney biopsy of solid renal tumours less or equal to 4 cm and its impact on management.


METHODS
From January 2001 to October 2006, all solid renal tumours less or equal to 4 cm were systematically assessed by CT-guided percutaneous biopsy: 66 tumours were biopsied in 65 patients (one bilateral tumour) and four patients had a second biopsy. A total of 70 biopsies were performed.


RESULTS
Among the biopsies, 18% (12/66) were not contributive. Four were repeated and provided a diagnosis in 50% of cases. Two patients with non contributive biopsies were lost to follow-up. Seven benign tumours (10.9%) and 54 malignant tumours were diagnosed. The kidney biopsy diagnosed 91% (52/57) of malignant tumours and 57% (4/7) of benign tumours. The concordance between biopsy results and pathology results was 90.7% for histological type of tumour and 64% for Fuhrman nuclear grade. Histological type and tumour grade had no impact on the type of surgery performed (51 patients operated, 29 kidney-preserving procedures, by necessity in seven cases). Four patients (6.3%) in whom a benign tumour was diagnosed on biopsy were simply followed, thereby avoiding surgery.


CONCLUSIONS
This series revealed 10.9% of benign tumours, only 57% of which were diagnosed by biopsy. Management was modified for only four patients (6.3%). Kidney biopsy remains an option in the pretreatment assessment of renal tumours less or equal to 4 cm, but cannot be proposed systematically.
Service d'urologie, CHU Nord, chemin des Bourrely, 13015 Marseille, France. stanislas.rybikowski@mail.ap-hm.fr
S
S
Rybikowski
L
L
Tomatis
F
F
Arroua
E
E
Ragni
D
D
Rossi
C
C
Bastide
D000368:Aged; D001706:Biopsy / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed