{"id":4334,"date":"2021-10-30T10:11:55","date_gmt":"2021-10-30T03:11:55","guid":{"rendered":"https:\/\/drsoaraweeurology.com\/?p=4334"},"modified":"2026-08-28T03:36:49","modified_gmt":"2026-08-27T20:36:49","slug":"biopsia-del-tumore-renale-quando-e-come","status":"publish","type":"post","link":"https:\/\/drsoaraweeurology.com\/it\/2021\/10\/30\/renal-cancer-biopsy-when-and-how\/","title":{"rendered":"Biopsy of a Small Kidney Mass: When It Helps, and When It Does Not"},"content":{"rendered":"\n<div class=\"wp-block-columns coblocks-author-columns has-background is-layout-flex wp-container-core-columns-is-layout-52275889 wp-block-columns-is-layout-flex\" style=\"background-color:#8C8C971A;padding-top:2.5rem;padding-right:2.5rem;padding-bottom:2.5rem;padding-left:2.5rem\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:25%\">\n<figure class=\"wp-block-image size-full is-style-rounded\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"800\" data-attachment-id=\"7037\" data-permalink=\"https:\/\/drsoaraweeurology.com\/it\/new-photo-2024\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" data-orig-size=\"800,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=800%2C800&#038;ssl=1\" alt=\"Best Urologist working in Chonburi and Cambodia\" class=\"wp-image-7037\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?w=800&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=300%2C300&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=150%2C150&amp;ssl=1 150w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=768%2C768&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=12%2C12&amp;ssl=1 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color: #00CCBB; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M19.586 0c-.818 0-1.508.19-2.073.565-.563.377-.97.936-1.213 1.68a3.193 3.193 0 0 0-.112.437 8.365 8.365 0 0 0-.078.53 9 9 0 0 0-.05.727c-.01.282-.013.621-.013 1.016a31.121 31.121 0 0 0 .014 1.017 9 9 0 0 0 .05.727 7.946 7.946 0 0 0 .077.53h.001c.024.115.06.262.112.438.243.743.65 1.303 1.213 1.68.565.376 1.255.564 2.073.564.8 0 1.536-.213 2.105-.603.57-.39.94-.916 1.175-1.65.076-.235.135-.558.177-.93a15.4 15.4 0 0 0 .063-1.207v-.512a.27.27 0 0 0-.273-.273h-2.95a.27.27 0 0 0-.274.273v.785c0 .228.0.343.273.343h1.337c.094 0 .14.045.14.137 0 .61-.063 1.043-.155 1.318-.182.546-.7 1.018-1.683 1.018-.654 0-1.135-.114-1.475-.356-.34-.244-.55-.585-.658-1.024a3.797 3.797 0 0 1-.111-.43 5.515 5.515 0 0 1-.06-.51 19.85 19.85 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1-.064.262c-.13.523-.402.913-.815 1.17-.413.255-.95.382-1.61.382z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/orcid.org\/0009-0004-8387-3559\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"ORCID iD\"\n     aria-label=\"View ORCID Profile\"\n     style=\"text-decoration: none; color: #A6CE39; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M12 0C5.372 0 0 5.372 0 12s5.372 12 12 12 12-5.372 12-12S18.628 0 12 0zM7.369 4.378c.525 0 .947.431.947.947 0 .525-.422.947-.947.947-.525 0-.946-.422-.946-.947 0-.525.421-.947.946-.947zm-.722 3.038h1.444v10.041H6.647V7.416zm3.562 0h3.9c3.712 0 5.344 2.653 5.344 5.025 0 2.578-2.016 5.025-5.325 5.025h-3.919V7.416zm1.444 1.303v7.444h2.297c3.272 0 4.022-2.484 4.022-3.722 0-2.016-1.284-3.722-4.097-3.722h-2.222z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/scholar.google.com\/citations?user=lTgsRMUAAAAJ&#038;hl=en\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"Google Scholar\"\n     aria-label=\"View Google Scholar Profile\"\n     style=\"text-decoration: none; color: #4285F4; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M5.242 13.769L0.5 9.5 12 1l11.5 8.5-4.742 4.269C17.548 11.249 14.978 9.5 12 9.5c-2.977 0-5.548 1.748-6.758 4.269zM12 10a7 7 0 1 0 0 14 7 7 0 0 0 0-14z\"\/>\n    <\/svg>\n  <\/a>\n  \n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Kidney cancer is usually silent, and most kidney masses today are found by accident \u2014 on a scan done for something else, or as part of a health-check package. A <strong>small renal mass<\/strong> means a solid kidney lesion under four centimetres, and it presents a genuine dilemma: it might be cancer, and it might not.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Broadly, around eight in ten turn out to be malignant and two in ten benign \u2014 with the benign proportion higher the smaller the lesion. Removing all of them means operating on a substantial number of people who never needed it, which is the problem biopsy was introduced to solve.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Urology center Bangkok hospital Thailand\u00a0<a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Booking online<\/a>\u00a0<a href=\"tel:02-310-3009\">02-310-3009<\/a>\u00a0<a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a><\/li>\n\n\n\n<li>Samitivej Sriracha hospital Chonburi&nbsp;<a href=\"tel:088-022-1445\">088-022-1445<\/a><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">The question is not whether biopsy is possible<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">It is <strong>whether the result would change anything.<\/strong> That principle was implied in the earlier version of this article and is worth stating outright, because it decides who should have one.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Where a biopsy earns its place<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Before ablation<\/strong> \u2014 freezing or heating the tumour destroys it without producing a specimen, so the diagnosis has to be made beforehand.<\/li>\n\n\n\n<li><strong>Where surgery would be a serious undertaking<\/strong> \u2014 an older patient, significant heart or lung disease, one kidney, or poor kidney function. Knowing whether the lesion is benign changes whether the risk is worth taking.<\/li>\n\n\n\n<li><strong>Where surveillance is being considered<\/strong> rather than treatment, and the patient wants to know what is being watched.<\/li>\n\n\n\n<li><strong>Where the mass might not be a primary kidney cancer at all<\/strong> \u2014 lymphoma, or a deposit from a cancer elsewhere, both of which are treated by an oncologist rather than a surgeon.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Where it can reasonably be skipped \u2014 absent from the earlier version<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>A fit patient with a clearly suspicious mass who is proceeding to surgery anyway.<\/strong> The operation provides the diagnosis, and a biopsy adds a procedure without changing the plan.<\/li>\n\n\n\n<li><strong>A mass containing visible fat on CT<\/strong>, which is characteristic enough of a benign angiomyolipoma that a needle is not needed.<\/li>\n\n\n\n<li><strong>Predominantly cystic lesions<\/strong>, which biopsy samples poorly and which are assessed and followed on imaging instead.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"571\" data-attachment-id=\"4345\" data-permalink=\"https:\/\/drsoaraweeurology.com\/it\/2021\/10\/30\/renal-cancer-biopsy-when-and-how\/the-doctor-examines-advises-and-dispenses-medications-to-patients\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/10\/OPD-case.jpg?fit=1200%2C857&amp;ssl=1\" data-orig-size=\"1200,857\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;Prakasit Khuansuwan&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;Hospital service concept flat vector illustration. The doctor examines, advises and dispenses medications to patients in the hospital examination room.&quot;,&quot;created_timestamp&quot;:&quot;1630164941&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;The doctor examines, advises and dispenses medications to patients&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Renal mass biopsy can be done as out-patient basis.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Renal mass biopsy can be done as out-patient basis.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/10\/OPD-case.jpg?fit=800%2C571&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/10\/OPD-case.jpg?resize=800%2C571&#038;ssl=1\" alt=\"Renal mass biopsy performed as an outpatient procedure under image guidance\" class=\"wp-image-4345\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/10\/OPD-case.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/10\/OPD-case.jpg?resize=300%2C214&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/10\/OPD-case.jpg?resize=1024%2C731&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/10\/OPD-case.jpg?resize=768%2C548&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/10\/OPD-case.jpg?resize=18%2C12&amp;ssl=1 18w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">An outpatient procedure \u2014 the decision beforehand matters more than the procedure itself.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">What the procedure involves<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">You lie face down, local anaesthetic is injected over the flank, and two or three tissue cores are taken with a fine needle guided by ultrasound or CT. It is an outpatient procedure, usually with a period of observation afterwards.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Access is harder where there is a lot of body fat between skin and kidney, and posterior masses are easier to reach than those at the front. <strong>Blood-thinning medication has to be discussed and usually paused beforehand<\/strong> \u2014 this is a needle into a highly vascular organ, and that discussion was missing from the earlier version. Do not stop such medication on your own; the timing is arranged with the prescriber.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">The limitation that matters most<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The earlier version quoted an accuracy of up to 92% and a complication rate under 2%. Both figures are fair. <strong>What was missing is the number patients actually need.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Roughly <strong>one biopsy in ten comes back non-diagnostic<\/strong> \u2014 not benign, not malignant, simply not enough usable tissue to say. The 92% figure describes how accurate the answer is <em>when there is an answer<\/em>; it is not the chance of getting one. A non-diagnostic result usually leads to a repeat biopsy, and the second attempt is often successful.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">And the consequence that follows: <strong>a non-diagnostic biopsy does not mean the mass is benign.<\/strong> A suspicious lesion with an inconclusive biopsy is still a suspicious lesion, and is managed as one.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Risks<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Bleeding around the kidney<\/strong> \u2014 the commonest, usually minor and self-limiting, occasionally requiring transfusion or a procedure to stop it.<\/li>\n\n\n\n<li><strong>Blood in the urine and flank pain<\/strong>, generally settling within days.<\/li>\n\n\n\n<li><strong>Air in the chest cavity<\/strong>, uncommon, and relevant for upper-pole masses close to the lung.<\/li>\n\n\n\n<li><strong>Tumour spreading along the needle track<\/strong> \u2014 a long-standing worry that modern technique has reduced to something close to negligible. It is worth mentioning precisely because patients ask, and the honest answer reassures.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">What happens with the result<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">If it shows cancer<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">The options are <strong>surgery<\/strong> \u2014 removing the tumour and sparing the rest of the kidney where possible \u2014 <strong>ablation<\/strong>, or <strong>active surveillance<\/strong>. That last one deserves more than a mention in a list, because it is frequently the right answer and patients rarely expect it: <strong>many small kidney cancers grow very slowly, and in an older person with other conditions, watching a small tumour on scans is often safer than operating on it.<\/strong> The biopsy result and the grade help decide which.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">If it shows a benign mass \u2014 a correction<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">The earlier version said that a benign result leads to surveillance, with repeat biopsy considered if the mass exceeds 4 cm or grows faster than 5 mm a year. <strong>Those thresholds are the triggers for reconsidering treatment during surveillance, not for repeating a biopsy<\/strong>, and the statement has been rewritten.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">What actually follows depends on <em>which<\/em> benign diagnosis it is \u2014 they behave differently and are followed differently. And the point behind the confusion is worth keeping: <strong>a benign biopsy is reassuring rather than final.<\/strong> A needle samples part of a lesion, so a mass that continues to enlarge is reassessed regardless of what the first biopsy said. Surveillance is not discharge.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"4347\" data-permalink=\"https:\/\/drsoaraweeurology.com\/it\/2021\/10\/30\/renal-cancer-biopsy-when-and-how\/patient-doctor-online-consultation\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/10\/Doctor-patient-discuss.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;3.2&quot;,&quot;credit&quot;:&quot;francescoridolfi.com&quot;,&quot;camera&quot;:&quot;NIKON D850&quot;,&quot;caption&quot;:&quot;Back view of young woman making video call with her doctor while staying at home. Close up of patient sitting on armchair video conferencing with general practitioner on digital tablet. Sick girl in online consultation with a mature physician.&quot;,&quot;created_timestamp&quot;:&quot;1585142761&quot;,&quot;copyright&quot;:&quot;francescoridolfi.com&quot;,&quot;focal_length&quot;:&quot;85&quot;,&quot;iso&quot;:&quot;640&quot;,&quot;shutter_speed&quot;:&quot;0.01&quot;,&quot;title&quot;:&quot;Patient doctor online consultation&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Small renal mass issue is a sensitive problem which need sharing the decision making and good relationship between urologist and the patients.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Small renal mass issue is a sensitive problem which need sharing the decision making and good relationship between urologist and the patients.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/10\/Doctor-patient-discuss.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/10\/Doctor-patient-discuss.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Discussion between urologist and patient about management of a small kidney mass\" class=\"wp-image-4347\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/10\/Doctor-patient-discuss.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/10\/Doctor-patient-discuss.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/10\/Doctor-patient-discuss.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/10\/Doctor-patient-discuss.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/10\/Doctor-patient-discuss.jpg?resize=18%2C12&amp;ssl=1 18w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Whether to biopsy, treat or watch is a decision made together \u2014 there is rarely one right answer.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">Symptoms that need attention the same day<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">In an emergency in Thailand, call <strong>1669<\/strong>.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>After a biopsy:<\/strong> severe or worsening flank pain, heavy bleeding or clots in the urine, dizziness, breathlessness or a racing pulse, or fever.<\/li>\n\n\n\n<li><strong>Visible blood in the urine<\/strong> that has not been investigated \u2014 see <a href=\"https:\/\/drsoaraweeurology.com\/2021\/01\/15\/microscopic-hematuria\/\">blood in the urine<\/a>.<\/li>\n\n\n\n<li><strong>A mass you can feel in the abdomen or flank<\/strong>, or persistent flank pain with weight loss or fevers.<\/li>\n\n\n\n<li><strong>New swelling of the legs, or a varicocele appearing on the right side<\/strong> \u2014 see <a href=\"https:\/\/drsoaraweeurology.com\/2021\/03\/05\/varicocele-varicose-vein-testicle\/\">varicocele<\/a>, where this is explained as a reason to image the abdomen.<\/li>\n\n\n\n<li><strong>A scan report mentioning a kidney lesion that was never followed up.<\/strong> Not urgent today, and the item most likely to matter.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions About Kidney Mass Biopsy<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Do I need a biopsy of my kidney mass?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Only if the result would change what happens next. It is valuable before ablation, where surgery carries significant risk, where surveillance is being considered, or where the mass might not be a primary kidney cancer. A fit patient proceeding to surgery anyway, a mass containing fat on CT, and predominantly cystic lesions can reasonably skip it.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">How accurate is it?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Highly accurate when it yields an answer \u2014 up to around 92%. What matters alongside that is that roughly one biopsy in ten is non-diagnostic, meaning not enough usable tissue to say either way. That usually leads to a repeat, and a non-diagnostic result does not mean the mass is benign.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Is it safe? Could the needle spread the cancer?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Complications occur in under 2% and are mostly bleeding around the kidney, blood in the urine and flank pain, almost always settling on their own. Spread along the needle track was a genuine historical concern and modern technique has reduced it to something close to negligible. Blood-thinning medication is reviewed beforehand.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">The biopsy showed a benign mass. Am I discharged?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">No. A needle samples part of a lesion, so a benign result is reassuring rather than final, and follow-up imaging continues. What that follow-up looks like depends on which benign diagnosis it is. A mass that keeps growing is reassessed regardless of the first result.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">If it is cancer, does it have to be removed?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Not necessarily. Many small kidney cancers grow very slowly, and in an older person with other medical conditions, monitoring a small tumour on scans is often safer than operating. Surgery, ablation and active surveillance are all legitimate options, and the biopsy result helps decide between them.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Arranging a consultation<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Dr. Soarawee Weerasopone sees patients at <a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\">Bangkok Hospital Headquarters<\/a> and at Samitivej Sriracha Hospital in Chonburi on <a href=\"tel:0880221445\">088-022-1445<\/a>. Bring the scan images themselves rather than only the report, together with any earlier scans \u2014 <strong>whether the lesion has changed since a previous scan is often the most useful single piece of information<\/strong> \u2014 and a list of your medicines including any blood thinner.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients \u2014 arrange it in advance by email to the Urology department at <a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a>. Samitivej Sriracha is in-person only. Enquiries about cost are answered by the hospital, not by this website.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Disclaimer:<\/strong> This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters, and is intended for education only. It is not medical advice, diagnosis or a prescription for any individual, and no advice, diagnosis or prescription is given through personal messaging channels or social media. Dr. Soarawee operates no public social media account; any account offering private consultation in his name is fraudulent. In an emergency in Thailand, call <strong>1669<\/strong>.<\/p>\n\n\n\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@graph\": [\n    {\n      \"@type\": \"MedicalWebPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/10\/15\/renal-cancer-biopsy-when-and-how\/#webpage\",\n      \"url\": \"https:\/\/drsoaraweeurology.com\/2021\/10\/15\/renal-cancer-biopsy-when-and-how\/\",\n      \"name\": \"Biopsy of a Small Kidney Mass: When It Helps, and When It Does Not\",\n      \"description\": \"Renal mass biopsy is indicated where the result changes management. Around one in ten is non-diagnostic, a non-diagnostic or benign result does not exclude malignancy, and some patients can reasonably skip biopsy.\",\n      \"inLanguage\": \"en\",\n      \"datePublished\": \"2021-10-15\",\n      \"dateModified\": \"2026-08-28\",\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#website\" },\n      \"author\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"reviewedBy\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"publisher\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"about\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/10\/15\/renal-cancer-biopsy-when-and-how\/#renal-biopsy\" },\n      \"audience\": { \"@type\": \"MedicalAudience\", \"audienceType\": \"Patient\" },\n      \"disambiguatingDescription\": \"The earlier version quoted diagnostic accuracy of up to 92 percent without stating the non-diagnostic rate of approximately one in ten, which describes the chance of obtaining an answer at all rather than the accuracy of an answer once obtained. 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Complications occur in under two percent, mostly perinephric bleeding, haematuria and flank pain, which almost always settle spontaneously.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"My kidney mass biopsy was benign. Am I discharged?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"No. A needle samples only part of a lesion, so a benign result is reassuring rather than final and imaging follow-up continues. A mass that keeps growing is reassessed regardless of the first result.\" }\n        }\n      ]\n    }\n  ]\n}\n<\/script>\n","protected":false},"excerpt":{"rendered":"<p>A needle sample of a kidney lesion found by chance on a scan. It can spare an unnecessary operation \u2014 but roughly one in ten comes back with no answer at all, and a benign result is not the same as a final one.<\/p>","protected":false},"author":185281453,"featured_media":10089,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"Renal mass biopsy for small kidney lesions: who benefits, the non-diagnostic rate, why a benign result still needs follow-up, and who can skip the biopsy entirely.","jetpack_seo_html_title":"Renal Mass Biopsy: When It Is Needed | Dr. Soarawee Bangkok","jetpack_seo_noindex":false,"jetpack_seo_schema_type":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_wpcom_ai_launchpad_first_post":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"{title}\n\n{excerpt}\n\n{url}","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_wpas_customize_per_network":false,"jetpack_post_was_ever_published":false},"categories":[1364],"tags":[1559,1558,1557],"class_list":["post-4334","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-oncology","tag-biopsy","tag-kidney-cancer","tag-renal-cancer"],"jetpack_publicize_connections":[],"jetpack_likes_enabled":false,"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/pgZdrK-17U","jetpack_featured_media_url":"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/Renal-Cancer-Biopsy.webp?fit=1200%2C630&ssl=1","_links":{"self":[{"href":"https:\/\/drsoaraweeurology.com\/it\/wp-json\/wp\/v2\/posts\/4334","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoaraweeurology.com\/it\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoaraweeurology.com\/it\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/it\/wp-json\/wp\/v2\/users\/185281453"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/it\/wp-json\/wp\/v2\/comments?post=4334"}],"version-history":[{"count":18,"href":"https:\/\/drsoaraweeurology.com\/it\/wp-json\/wp\/v2\/posts\/4334\/revisions"}],"predecessor-version":[{"id":11764,"href":"https:\/\/drsoaraweeurology.com\/it\/wp-json\/wp\/v2\/posts\/4334\/revisions\/11764"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/it\/wp-json\/wp\/v2\/media\/10089"}],"wp:attachment":[{"href":"https:\/\/drsoaraweeurology.com\/it\/wp-json\/wp\/v2\/media?parent=4334"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/it\/wp-json\/wp\/v2\/categories?post=4334"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/it\/wp-json\/wp\/v2\/tags?post=4334"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}