A 65-year-old man with a 2.5 cm solid renal mass is being considered for radiofrequency ablation. His GFR is 58 mL/min. Before proceeding with ablation, which investigation is mandatory?
- A Bone scan
- B PET-CT to rule out metastasis
- C CT-guided core needle biopsy of the mass ✓
- D Renal angiography
Correct answer: C. CT-guided core needle biopsy of the mass
Explanation
Percutaneous renal mass biopsy is indicated before thermal ablation (RFA/cryoablation) to confirm malignancy and guide treatment. Unlike surgical excision where histology is obtained, ablation destroys tissue. Biopsy is also useful when the diagnosis is uncertain or when considering active surveillance. PET-CT and bone scan are not standard staging for renal cell carcinoma.
Reference: Campbell-Walsh-Wein Urology, 12th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.