Renal mass biopsies can be conducted with accuracy in patients with small renal masses (<4 cm), according to an article published online ahead of print in The Journal of Urology.1

Cross-sectional imaging has been the primary tool for the evaluation and diagnosis of renal masses, while renal biopsies have been reserved for the diagnosis of metastatic disease, infection, or lymphoma.2

Investigators evaluated 442 biopsies in small renal masses (<4 cm) between 2008 and 2015 to determine if renal cell carcinomas would be diagnosed accurately.

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From an initial biopsy, 393 cases (88.9%) were diagnostic, and 76% of those cases were renal cell carcinomas; 24% were benign. Forty-nine cases (11.1%) were non-diagnostic, and after a second biopsy, 100% were diagnostic.

Renal mass biopsies were 97.1% accurate in identifying malignances, 95.1% accurate in histotyping, and 68.8% accurate in grading between the biopsy and surgical pathology.

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Small renal mass biopsies can provide diagnostic information such as tissue histology and malignancy status. Non-diagnostic biopsies are more likely to occur in this patient population and a second a biopsy is a reasonable option.


  1. Jeon HG, Seo SI, Chang Jeong B, et al[LB1] . Percutaneous kidney biopsy for a small renal mass: a critical appraisal of results. [published online ahead of print September 24, 2015]. J Urol. doi: 10.1016/j.juro.2015.09.073.
  2. Sahni VA, Silverman SG. Biopsy of renal masses: when and why. Cancer Imaging. 2009;9(1):44-55.