The current role of percutaneous biopsy in the evaluation of renal masses

Percutaneous biopsy of intraabdominal masses is a safe and accurate means of obtaining a tissue diagnosis without surgical exploration. It is often sufficient to determine treatment plans and in many instances, obviates the need for surgery. Percutaneous biopsy of renal masses has traditionally had a limited role in the United States. However, with a recent increase in the detection of small renal masses because of the widespread use of abdominal computed tomography (CT), there is an increasing role for percutaneous biopsy in the management of renal masses. Percutaneous biopsy of renal masses is indicated to differentiate between a primary renal cell carcinoma and metastatic disease in patients with a known extrarenal primary. Percutaneous biopsy is also indicated to establish a diagnosis of renal lymphoma and abscess. Complications of percutaneous biopsy include bleeding, pneumothorax, and tumor seeding along the needle tract; fortunately, these complications are uncommon. We will review the indications, techniques, complications, sensitivity, and accuracy of CT and ultrasound-guided biopsy of renal masses. Urologists and radiologists should both be familiar with the indications and contraindications of percutaneous biopsy to insure the appropriate management of renal masses.