Evaluation the results and complications of biopsy of small renal masses and comparison of its pathological findings with the main tissue after surgery

Abstract

The widespread adoption of imaging in the diagnostic workup of many diseases has led to a significant increase in the detection of small renal masses (SRM) (diameter ≤4 cm). These masses are a heterogeneous group of tumors that include a full spectrum of metastatic potential. Modern techniques such as ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) are highly sensitive for diagnosing SRM, but none of them are capable of accurate and reliable identification in terms of histological features. Renal tumor biopsies (RTBs) have been proposed as a safe and useful tool to detect benign and malignant tumors before treatment and to avoid unnecessary interventions. To date, several studies have reported high diagnostic accuracy of biopsy (sensitivity 89% and specificity 60%) with an acceptably low complication rate; however, most of the studies are limited due to small sample sizes and/or the long time required for analysis. Hence, according to the research findings in the field, the management of SRM is challenging, and determining the true role of kidney biopsy in revealing the actual gender of the mass and investigating related complications requires further studies. In this study, we examined the complications and results of biopsies for small renal masses and compared the pathological findings with the original tissue after surgery. Methods: This study was conducted on 250 patients diagnosed with a small renal mass who underwent biopsy at Imam Reza and Sina Hospitals in Tabriz. Data related to demographic information, i.e. details about to the mass, including the side of the involved kidney, location of the mass, type of mass, tumor size, type of imaging, biopsy pathology/cytology results, and complications caused by biopsy were collected and analyzed through file reading. Results: In this study, the number of patients with small renal masses on the right side was greater than on the left side of the kidney (153 patients versus 95 patients). There were more tumors in the middle (106 patients) than at the upper (72 patients) and the lower kidney (72 patients). The most common side effects were hematuria, nausea and vomiting, and pain. No tumor implantation or significant bleeding was observed. In examining the results of pathology/after biopsy, 44% of patients had benign tumors and 56% had malignant tumors. Malignant patients (140 patients) underwent surgery after diagnostic biopsy. The histological concordance of biopsy and surgical samples was 100%.