title: Is there a contemporary role for percutaneous needle biopsy in the era of small renal masses?
abstract: OBJECTIVE
  To evaluate based on the best available data whether there is a contemporary role for percutaneous needle biopsy in the era of small renal masses.
  
  
  METHODS
  SRMs are acknowledged to be tumours less than 4cm and account for 48%-66% of new kidney cancers. Renal mass biopsy (RMB), traditionally limited to specific clinical scenarios and with inherent diagnostic accuracy problems has increased in popularity in recent years and is a potential valuable tool in the assessment of SRMs. Our discussion focuses on these issues. We performed a thorough Medline literature review using a combination of the following keywords; small renal mass, renal biopsy, percutaneous renal biopsy, renal mass biopsy and renal cell carcinoma. We identified the seminal articles with data/information pertaining to renal mass biopsy in small renal masses.
  
  
  RESULTS
  The facts that 1) a significant number of SRMs are diagnosed in an elderly patient cohort, 2) 20% of SRMs are benign on formal histology, 3) there are various management strategies now available and 4) modern RMB has a diagnostic accuracy >90% with few complications, are all reasons why there has been renewed interest in RMB.
  
  
  CONCLUSIONS
  There is a contemporary role for RMB in the era of SRM as the incorporation of molecular profiling of tissue from RMB would augment our ability to risk stratify SRMs on an individual patient basis and adopt management accordingly. However, clinical judgement is paramount as there remains an unpredictable non-negligible risk of disease progression and metastasis whilst on surveillance.
authors: Academic Department of Urology and of Radiology of La Pitié-Salpétrière Tenon, University Paris VI, Paris, France.
authors: Véronique
authors: V
authors: Phé
authors: David R
authors: DR
authors: Yates
authors: Raphaële
authors: R
authors: Renard-Penna
authors: Olivier
authors: O
authors: Cussenot
authors: Morgan
authors: M
authors: Rouprêt
mesh_terms: D044963:Biopsy, Fine-Needle / Q000379:methods; D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000473:pathology*; D003952:Diagnostic Imaging / Q000379:methods; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000473:pathology*; D012680:Sensitivity and Specificity