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Muttin et al. Mini-invasive Surg 2019;3:10 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2018.005

Review Open Access

The role of the renal biopsy and surveillance in the
management of small renal masses

Fabio Muttin , Eric Barret 2
1
1 Unit of Urology, Division of Experimental Oncology, Urological Research Institute (URI), IRCCS San Raffaele Scientific
Institute, Vita-Salute San Raffaele University, 20132 Milano, Italy.
2 Department of Urology, Institut Mutualiste Montsouris, Paris 75014, France.
Correspondence to: Dr. Eric Barret, Department of Urology, Institut Mutualiste Montsouris, Paris 75014, France.
E-mail: eric.barret@imm.fr

How to cite this article: Muttin F, Barret E. The role of the renal biopsy and surveillance in the management of small renal
masses. Mini-invasive Surg 2019;3:10. http://dx.doi.org/10.20517/2574-1225.2018.005

Received: 30 Nov 2018 First Decision: 14 Jan 2019 Revised: 7 Mar 2019 Accepted: 11 Mar 2019 Published: 17 Apr 2019

Science Editor: Richard Lawrence John Naspro Copy Editor: Cai-Hong Wang Production Editor: Huan-Liang Wu

Abstract
Cross-sectional imaging shows a limited diagnostic accuracy for the histological discrimination of small renal masses
(SRM). In this scenario, a renal tumor biopsy is a safe, feasible and effective diagnostic tool that can guide treatment
strategy by providing the histological characterization of a SRM. Although nephron-sparing surgery is still considered
the gold standard treatment for patients with SRM, more and more evidence suggests that active surveillance (AS) is
a reasonable alternative option, especially in old and comorbid patients. Indeed, owing to the relatively slow growth
and favorable biology of SRM, AS followed up by, if necessary, a delayed intervention provides an optimal oncological
outcome with low rates of systemic progression or death.

Keywords: Small renal masses, cross-sectional imaging, renal biopsy, surveillance

INTRODUCTION
Traditionally, kidney cancer is one of the few tumors that is only treated if there is a radiological probability
of malignancy. This concern is related to the limited diagnostic accuracy of computed tomography and
[1]
magnetic resonance imaging in the histologic characterization of small renal masses (SRM) . In recent
years, a percutaneous renal tumor biopsy (RTB) has emerged as a promising diagnostic tool that may help
in the clinical decision-making process by distinguishing benign from malignant radiological inconclusive
renal lesions, and thus may be considered suitable for patients who are candidates for either active
[1-3]
surveillance or nephron-sparing treatments .
© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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