The Role of Pathology in Small Renal Mass Laparoscopic Cryoablation

Objective . We evaluated histological outcome of intraoperative biopsies at laparoscopic renal mass cryoablation (LCA), prevalence of peritumoral fat tissue invasion, and risk of tract seeding. Methods . Patients were biopsied 3–5 times (16-gauge). Histology was analyzed by general pathologists and reviewed. Peritumoral fat was histologically examined. The trocar used for biopsy-guidance was examined by cytology. Records were studied for reporting tract metastasis. Results . 77 biopsied renal masses with mean ± SD diameter 30 ± 7.4 mm were histologically classified by primary and review pathology revealing 64 and 62 malignancies, 13 and 15 benign lesions, respectively. In 30/34, the fat covered a carcinoma but revealed no malignancy. Cytology showed no malignant cells but was inconclusive in 1 case. No tract metastasis occurred. Conclusions . The use of an intraoperative biopsy protocol provides histological diagnosis of all renal masses. No existence of peritumoral fat tissue invasion or tract seeding was found.