What are the AUA guidelines for renal mass biopsy in the diagnosis of renal cell carcinoma (RCC)?

Updated: Feb 19, 2021
  • Author: Kush Sachdeva, MD; Chief Editor: E Jason Abel, MD  more...
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According to the AUA guideline, a renal mass biopsy should be considered when a mass is suspected to be hematologic, metastatic, inflammatory, or infectious (Clinical Principle). In the setting of a solid renal mass, biopsy is not required for either of the following (Expert Opinion):

  • Young or healthy patients who are unwilling to accept the uncertainties associated with biopsy
  • Older or frail patients who will be managed conservatively independent of biopsy findings

When considering the utility of renal mass biopsy, patients should be counseled regarding its rationale, positive and negative predictive values, potential risks, and nondiagnostic rates (Clinical Principle). For patients with a solid renal mass who elect biopsy, multiple core biopsies are preferred over fine needle aspiration (Moderate Recommendation; Evidence Level: Grade C)

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