A 62-year-old man presents with a one-week history of hematuria. Ultrasound and computed tomography identify a 7-cm exophytic anterior left renal tumor, adenopathy, and two
small lung nodules. No bone or central nervous system lesions are detected. His Eastern Cooperative Oncology Group (ECOG) performance-status (PS) and Memorial Sloan-Kettering Cancer Center (MSKCC) scores are 1. The patient asks whether to undergo cytoreductive nephrectomy. What do you tell him?
Centers of Excellence
Kidney Cancer Today
Small Renal Masses: To Biopsy or Not to Biopsy?
Biopsy or not to biopsy...that is the question in this debate between Jaime Landman and Michael Staehler hosted by Monty Pal. Do we biopsy the small renal mass patient or do we diagnose the patient using exclusively imaging? The case is made by Jaime to consider why this is the only cancer we do not routinely biopsy. They discuss why the approach in small renal masses is unique.

Sumanta (Monty) Kumar Pal, MD, is an internationally recognized leader in the area of genitourinary cancers, including kidney, bladder, and prostate cancer. He is the Co-director of City of Hope's Kidney Cancer Program and is the head of the kidney and bladder cancer disease. Dr. Pal sits on the Editorial Board for clinical genitourinary cancer and is a reviewer for multiple journals including The Journal of Clinical Oncology, The Journal of Urology, European Urology, and many others.

Jaime Landman, MD, director of the UCI Health Center for Urological Care, is an internationally recognized urologist and expert in diseases and conditions of the kidneys, including kidney stones and benign and malignant tumors. He is experienced in all forms of minimally invasive kidney surgery, including robot-assisted surgery and percutaneous cryoablation. Dr. Landman, who founded the UCI Health Ablative Oncology Center, has performed more than 2,000 advanced minimally invasive kidney procedures. He is dedicated to improving the techniques and technology associated with minimally invasive surgery.