Renal mass biopsy an oncological conundrumPatel, Roshan M.; Parkhomenko, Egor; Kaler, Kamaljot S.; Okhunov, Zhamshid; Clayman, Ralph V.; Landman, JaimeCurrent Opinion in Urology: July 2018 - Volume 28 - Issue 4 - p 360–363 doi: 10.1097/MOU.0000000000000515 CURRENT EVIDENCE AND BEST PRACTICE IN RENAL AND PROSTATE BIOPSY: Edited by Mesut Remzi and Jaime Landman Buy Abstract Author InformationAuthors Article MetricsMetrics Purpose of review We evaluate the reasons that the majority of urologists infrequently biopsy a T1a small renal mass (SRM). Recent findings The majority of urologists report that a renal mass biopsy will not change their management in patients with a SRM given concerns of safety and efficacy of the biopsy. However, when comparing the safety and efficacy of SRM biopsy with neoplasms in all other major organ systems (all of which require biopsy prior to treatment), renal mass biopsy results are favorable. In addition to being safe and effective, renal mass biopsy should be more cost-effective for the healthcare system. Finally, in properly selected patients, renal mass biopsy can be performed in the urologist's office, thereby further decreasing cost. Summary Renal mass biopsy is an essential clinical tool that needs to be incorporated into the decision-making process among patients with a T1a SRM. A biopsy-driven, tissue-specific diagnosis of SRMes should become the standard of care in urology to bring us to parity with standard practice to management of lesions identified in every other organ system. Department of Urology, University of California, Irvine, Orange, California, USA Correspondence to Roshan M. Patel, MD, Clinical Instructor, Department of Urology, University of California, Irvine, 333 City Blvd. West, Suite 2100, Irvine, CA 92868, USA. Tel: +1 714 456 6849; fax: +1 888 378 4358; e-mail: email@example.com Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.