title: The role of biopsy in incidental renal tumours.
abstract: OBJECTIVE
  Historically, the biopsy of renal masses was not advocated, and to date there remains some controversy on the role of biopsy for renal masses in making treatment decisions. With the widespread use of imaging methods, the incidental diagnosis of renal masses has increased, necessitating renal biopsies to better plan the management of these tumours. Here I review previous reports to define the role of biopsy in incidental renal tumours.
  
  
  METHODS
  Data were obtained from English-language studies listed in PubMed on the use of renal biopsy for evaluating incidental solid small renal tumours.
  
  
  RESULTS
  The biopsy of small renal tumours is increasingly accepted due to: the increase in the incidence of small renal tumours; the finding that a significant number of these tumours are benign; the availability of new management options, such as ablative therapy and surveillance strategies; that imaging alone is unable to predict the biological behaviour of these tumours; and advances in the pathological evaluation of the biopsies. The biopsy procedure has an acceptable complication rate but is not free of limitations. The current recommendations for the use of renal biopsy in small renal tumours are: to help in differentiating benign from malignant renal tumours; before or during ablative therapies and during the follow-up after ablative therapies, for defining treatment success or failure; and to exclude nonrenal cell primary tumours (metastasis and lymphoma) or benign conditions (abscess), which may not require surgery.
  
  
  CONCLUSIONS
  The biopsy of small renal tumours is a safe and accurate procedure, and can help in the planning of definitive patient management.
authors.affiliation: Urology Division, Department of Surgery, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, Al-Khod 123, Oman.
authors.forename: Mohammed S
authors.initials: MS
authors.lastname: Al-Marhoon
keywords: FNA, Fine-needle aspiration; Renal cell cancer; Renal tumour biopsy; Small renal tumours