Clinical Case Reports

Biography

Biography: Deanne Soares

Abstract

Percutaneous biopsies have been found to be useful in the diagnosis and management of renal masses and have a very low complication rate. However, one possible hazard of this is tumour seeding along the tract, but this is so rare in renal cell carcinoma (RCC) that its frequent use in the assessment of indeterminate renal masses has been warranted. We report a case of tumour seeding caused by percutaneous biopsy of a papillary renal cell carcinoma detected on pathological assessment of the partial nephrectomy specimen in a 50-year-old male. A review of the literature found that up until 1991, there were only 5 reported cases of RCC tract seeding and in 2013 there were a further 3 cases reported. In general, tract seeding relates to the amount of disruption of the tumour capsule (needle calibre, number of punctures), pressure of egress at the puncture site (for example, cystic masses or escaping haematoma), whether tumour cells are dropped from the needle on its withdrawal (failure to maintain negative pressure, burred needle tip), and the ability of tumour cells to survive when deposited into a scar. This is one of only a few contemporary case reports of RCC seeding along a percutaneous biopsy tract. Whilst this complication is so rare that it does not merit a need to discontinue the use of percutaneous biopsy of renal masses, it certainly highlights the possibility of tract seeding as a potential hazard. As such, certain considerations, such as appropriate patient selection, the use of correct equipment and suitable biopsy technique, should be made to minimise the risk of this complication