| Affiliation: | 1. Division of Urology, Department of Surgery, Duke University Medical Center, , Durham, NC, USA;2. Department of Urology, AMC University Hospital, , Amsterdam, The Netherlands;3. Department of Urology, UZ Leuven, , Leuven, Belgium;4. Department of Urology, University of Miami, , Miami, FL, USA;5. Section of Urology, Department of Surgery, Georgia Health Sciences University, , Augusta, GA, USA;6. Department of Urology, University of Southern California, , Los Angeles, CA, USA;7. Department of Radiology, Duke University Medical Center, , Durham, NC, USA;8. Department of Pathology, Johns Hopkins University Medical Center, , Baltimore, MD, USA;9. Department of Radiology, Baylor University Medical Center, , Dallas, TX, USA;10. Division of Urology, Department of Surgery, University of Cincinnati, , Cincinnati, OH, USA;11. Department of Urology, Medical University of Vienna, , Vienna, Austria;12. Department of Pathology, Duke University Medical Center, , Durham, NC, USA |
| Abstract: | - To discuss the use of renal mass biopsy (RMB) for small renal masses (SRMs), formulate technical aspects, outline potential pitfalls and provide recommendations for the practicing clinician.
- The meeting was conducted as an informal consensus process and no scoring system was used to measure the levels of agreement on the different topics.
- A moderated general discussion was used as the basis for consensus and arising issues were resolved at this point.
- A consensus was established and lack of agreement to topics or specific items was noted at this point.
- Recommended biopsy technique: at least two cores, sampling different tumour regions with ultrasonography being the preferred method of image guidance.
- Pathological interpretation: ‘non‐diagnostic samples’ should refer to insufficient material, inconclusive and normal renal parenchyma. For non‐diagnostic samples, a repeat biopsy is recommended. Fine‐needle aspiration may provide additional information but cannot substitute for core biopsy.
- Indications for RMB: biopsy is recommended in most cases except in patients with imaging or clinical characteristics indicative of pathology (syndromes, imaging characteristics) and cases whereby conservative management is not contemplated. RMB is recommended for active surveillance but not for watchful‐waiting candidates.
- We report the results of an international consensus meeting on the use of RMB for SRMs, defining the technique, pathological interpretation and indications.
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