Role of Percutaneous Needle Biopsy for Renal Masses

The role of percutaneous renal mass biopsy has expanded considerably in the past 10 years. The incidence of incidentally detected small (< 4 cm) solid renal masses is on the rise, and despite a commensurate increase in nephron-sparing treatment, the mortality rate from renal cell carcinoma remains the same. Earlier detection and treatment have not had dramatic effects on population outcome, implying that not all small renal masses will grow to be life-limiting. Indeed, many small solid renal masses are benign, and among those that are malignant, not all share the same malignant behavior. Percutaneous biopsy provides a minimally invasive method for discriminating benign from malignant renal masses, and portends the potential for stratifying malignant risk. With recent improvements in image-guided equipment and technique, percutaneous renal mass biopsy can be performed safely and effectively, with a low complication rate (< 5%) and a high diagnostic yield (> 90%).