In this episode of BackTable Urology, Dr. Aditya Bagrodia and Dr. Christopher Anderson (Columbia University) discuss the diagnosis and workup of kidney cancer, including renal biopsy techniques.

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SHOW NOTES

First, the doctors explore the importance of cross-sectional imaging and IV contrast to identify and manage small renal masses. Many factors are important, such as patient age and comorbidities, hereditary cancer predisposition syndromes, and size cut-off criterias. They also emphasize the importance of time in helping patients understand their diagnosis and the individualized approach to each case.

Then, they move on to discuss the role of biopsies in identifying and managing small renal masses. Biopsies can determine whether a tumor is malignant and help with treatment decisions. They also discuss the AUA guidelines for when to consider a real biopsy as well as the risks and benefits of biopsy procedures. Then, they give a short summary of a few biopsy techniques.

After the renal biopsy, a decision has to be made about whether or not to operate on a small renal mass. Aditya and Christopher emphasize the importance of understanding patient goals and the risks of accidentally removing a benign tumor. They also explore factors in deciding on which patients would benefit from treatment of indolent tumors. Biopsies can help avoid over-treatment if they can be used to reduce unnecessary operations. The doctors end by discussing the follow-up and the importance of close monitoring for any signs of recurrence.

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