701 PERCUTANEOUS BIOPSY OF SUSPICIOUS CYSTIC RENAL MASSES: WHAT IS THE DIAGNOSTIC YIELD?

Field: Medicine (Health Sciences)

You have accessJournal of UrologyKidney Cancer: Evaluation and Staging1 Apr 2011701 PERCUTANEOUS BIOPSY OF SUSPICIOUS CYSTIC RENAL MASSES: WHAT IS THE DIAGNOSTIC YIELD? Sameer M. Deshmukh, Luiz Sequeira, Francis McGovern, Douglas Dahl, Aria Olumi, Brian Eisner, W. Scott McDougal, Peter Mueller, Anthony Samir, and Adam S Feldman Sameer M. DeshmukhSameer M. Deshmukh Boston, MA More articles by this author , Luiz SequeiraLuiz Sequeira Boston, MA More articles by this author , Francis McGovernFrancis McGovern Boston, MA More articles by this author , Douglas DahlDouglas Dahl Boston, MA More articles by this author , Aria OlumiAria Olumi Boston, MA More articles by this author , Brian EisnerBrian Eisner Boston, MA More articles by this author , W. Scott McDougalW. Scott McDougal Boston, MA More articles by this author , Peter MuellerPeter Mueller Boston, MA More articles by this author , Anthony SamirAnthony Samir Boston, MA More articles by this author , and Adam S FeldmanAdam S Feldman Boston, MA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1668AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Percutaneous biopsy is an emerging modality in the study of small renal masses. We sought to review our experience with the pathologic diagnoses of cystic renal lesions biopsied at our institution from 1997-2010 in order to investigate the utility of this technique. METHODS Under IRB approval, we performed a retrospective review of a database containing 899 patients who had undergone percutaneous biopsy of renal masses. Core biopsies were performed using 15–18 gauge cutting needles and fine needle aspirations (FNAs) were performed with 20–23 gauge Chiba needles. 157/899 masses (17%) biopsied in this series were cystic, and serve as the cohort for this study. We collected and reviewed pre-biopsy imaging data, biopsy and surgical pathologic data, and clinical follow-up data. RESULTS Mean patient age was 63.9 years (range 25–88). Mean lesion size was 2.93 cm (± 1.76, range 0.8–11 cm). 43/157 (27%) were read as renal cell carcinoma (RCC). 33/157 (21%) of biopsies were non-diagnostic. 73/157 (46%) were read as benign tissue. 33/157 (21%) patients underwent radiofrequency ablation of their cystic mass. 30/157 (19%) underwent surgery (17 radical nephrectomy, 13 partial nephrectomy). 95% (18/19) of those with RCC on biopsy were RCC on final pathology. Of 73 masses with a biopsy diagnosis of “benign”, 7 went to surgery; 3/7 proved to be RCC, and 4/7 were benign cysts. Of 33 masses with a biopsy diagnosis of “non-diagnostic”, 4 went to surgery; all were RCC. Table 1 summarizes biopsy and surgical pathologic results. 95/106 (90%) of those lesions with “benign” or “non-diagnostic” results on biopsy underwent imaging surveillance. CONCLUSIONS Percutaneous renal biopsy of suspicious cystic renal masses has a high positive predictive value for RCC. However, a significant proportion of these biopsies return “non-diagnostic” and “benign” pathology and thus may have a relatively low diagnostic yield. Such negative biopsies must be followed closely over time with imaging surveillance. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185 Issue 4S April 2011 Page: e282 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Metrics Author Information Sameer M. Deshmukh Boston, MA More articles by this author Luiz Sequeira Boston, MA More articles by this author Francis McGovern Boston, MA More articles by this author Douglas Dahl Boston, MA More articles by this author Aria Olumi Boston, MA More articles by this author Brian Eisner Boston, MA More articles by this author W. Scott McDougal Boston, MA More articles by this author Peter Mueller Boston, MA More articles by this author Anthony Samir Boston, MA More articles by this author Adam S Feldman Boston, MA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...