ArticlePDF Available

Papillary Renal Cell Carcinoma Seeding along a Percutaneous Biopsy Tract

  • Douglass Hainly Moir Pathology, Sydney, Australia

Abstract and Figures

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. Whilst percutaneous biopsy of renal masses is considered to be safe and can be a valuable tool in the assessment of certain renal lesions, it is not without risks. This rare complication should be taken into consideration before contemplating its use in a patient.
This content is subject to copyright. Terms and conditions apply.
Case Report
Papillary Renal Cell Carcinoma Seeding along
a Percutaneous Biopsy Tract
Deanne Soares, Nariman Ahmadi, Oana Crainic, and John Boulas
Royal Prince Alfred Hospital, Missenden Road, Camperdown, Sydney, NSW 2050, Australia
Correspondence should be addressed to Deanne Soares;
Received  May ; Revised  July ; Accepted  July 
Academic Editor: Christian Pavlovich
Copyright ©  Deanne Soares et al. is is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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 -year-old male. Whilst percutaneous biopsy of renal masses is considered
to be safe and can be a valuable tool in the assessment of certain renal lesions, it is not without risks. is rare complication should
be taken into consideration before contemplating its use in a patient.
1. Introduction
e use of percutaneous biopsies is useful in the diagnosis
and management of renal masses and of other abdominal
organs [,]. is has been found to be a safe and eective
tool with a complication rate of less than .% []. However,
a potential hazard of this procedure is tumour seeding, where
malignant cells are deposited along the needle tract, but this is
so rare in renal cell carcinoma (RCC) that its frequent use in
the assessment of indeterminate renal masses has therefore
been justied [,]. Here we present a case of RCC seeding
on histopathological assessment of a partial nephrectomy
2. Case Presentation
A -year-old male was referred to our institution for review
aer an incidental nding of a . cm enhancing lower
pole mass on the le kidney. is mass was rst noted on
ultrasound imaging as part of his investigations for symptoms
of bloating and constipation. A computed tomography scan
with intravenous contrast was then performed to further
characterise this lesion, which showed a low density but
mildly enhancing lesion. Magnetic resonance imaging (MRI)
was performed to exclude angiomyolipoma. It revealed a
 × mm le renal lower pole exophytic mass with a low
T signal suggesting the possibility of a renal cell carcinoma
(see Figure ). e patient then underwent an ultrasound-
guided biopsy of the mass to aid with diagnosis and assist
in management options. e lesion was rst accessed using
a -gauge needle with a coaxial sheath and  ne needle
aspiration (FNA) biopsies were performed. is was followed
by core biopsies using an -gauge core biopsy needle also
done with the coaxial sheath in place. Two passes were
made to obtain  cores, all embedded in  blocks. e core
sizes were  mm,  mm,  mm, mm,  mm, and  mm in
length. Pathological assessment of the FNA and core biopsy
specimens conrmed the presence of a low-grade neoplasm
consisting of closely packed cells with small rounded nuclei
forming clusters and some mucin lled tubules. Given this
nding, the patient underwent a subsequent open le partial
nephrectomy  weeks later. e procedure involved a lower
pole partial nephrectomy, with frozen section conrming
clear parenchymal margins. e perinephric fat over the
tumour was initially reected o during surgery and sent
separately with a marking suture placed where the fat was
adherent over the tumour site. ere was no tumour capsule
disruption or spillage or any other complication during the
Macroscopically, there was a lobulated grey partly
necrotic, noncystic tumour measuring  × mm (see
Figure  showing the bisected specimen). Microscopically,
the lesion was well demarcated showing a complex papillary
Hindawi Publishing Corporation
Case Reports in Urology
Volume 2015, Article ID 925254, 4 pages
Case Reports in Urology
T : Summary of reported cases of RCC seeding along a renal percutaneous biopsy tract.
Reference (year) Typ e of
Interval between
biopsy and seeding Size Description and location
Gibbons et al.
() []RCC   months cm Firm mass inferior to the
posterior part of the right th rib
Auvert et al.
() []Oncocytoma Did not
mention years cm Subcutaneous mass at biopsy site
Kiser et al.
() []
RCC   month mm Nodule found when dissecting
Gerota’s fascia o psoas muscle
Wehl e and
Grabstald ()
RCC  Not specied Not specied Flank mass at biopsy site
Shenoy et al.
() []RCC   months . cm Subcutaneous nodule
Giorgadze et al.
() []
 (FNA)
 (Core) years  cm
Le retroperitoneal mass
extending posterior to the
abdominal aorta with possible
invasion into the psoas muscle
Mullins and
() []
 (FNA)
 (Core)  months . cm
Tumour invading the perirenal
fat within the previous biopsy
Sainani et al.
() []
 (FNA)
 (Core) years Up to . cm  retroperitoneal nodules and 
in the paraspinal musculature
F : Magnetic resonance imaging (MRI) showing a  × mm
le renal lower pole mass with a low T signal.
growth pattern (see Figure ). Immunochemically it was
strongly positive for both alpha-methyl CoA racemase and
CK. Histologically this was a type  papillary renal cell
carcinoma. During examination of the fat overlying the
tumour, viable tumour was noted seeding along the previous
percutaneous biopsy tract, with it growing within the brob-
lastic response that marked the biopsy tract (see Figures
and ). His recovery was uneventful and he was discharged
on day  postoperatively. He remained well  month aer his
procedure. Follow-up imaging will be sought.
3. Discussion
Tumour seeding in a biopsy tract has been well documented
in malignancies of solid organs such as in pancreatic and
lung adenocarcinoma as well as hepatocellular carcinoma
F : Macroscopic view of the partial nephrectomy specimen
demonstrating a  × mm well-demarcated tumour.
[]. However, the extension of a renal cell carcinoma along
a percutaneous biopsy tract is very rare with only a few
reported cases on this []. Gibbons et al. noted the
rst case of RCC tract seeding in ,  months aer
aspiration of a renal lesion using an -gauge needle [].
Tabl e  summarises all the previously reported cases of RCC
seeding along a renal percutaneous biopsy tract.
Up until , there were only  reported cases of RCC
tract seeding [] and in  there were further  cases
reported []. e size of the needle used during these
biopsies ranged from  to  gauges and were detected 
month to  years aer the initial biopsy was performed [].
A review by Herts and Baker in  found that needle tract
seeding from percutaneous renal mass biopsy is very rare
estimating the risk to be less than .% []. Nevertheless, this
is a potential risk and there have been some suggestions that
this risk is increased with the use of large gauge needles, more
Case Reports in Urology
F : High power view of the lesion demonstrating papillary
F : Fat overlying the tumour demonstrating papillary renal
cell carcinoma seeding along the previous percutaneous biopsy tract.
passes with the needle, and high tumour grade []. Also, the
use of coaxial biopsy technique, in which the biopsy specimen
is obtained with the use of an introducer sheath, has been
recommended in order to reduce the risk of tract seeding [].
In our case, this method was used and thus highlights the
fact that this does not completely eliminate the possibility of
tract seeding. Other technical recommendations to prevent
tumour seeding are to avoid multiple punctures of the tumour
capsule, to withdraw the needle under suction, and to wipe
the cores between passes []. In our case, both FNA and core
biopsies were done as the FNA sample was insucient and
 passes were made with the core biopsy needle which could
have contributed to the increased risk of seeding. Most of the
case reports do not specically mention the number of passes
made. In the case by Mullins and Rodriguez, there were 
passes made for FNA sampling and  passes made to obtain
the core samples. Also, there was no use of an introducer
sheath []. However, Sainani et al. reported the use of an
introducer sheath for the  FNA and  core samples they
obtained and yet found tumour seeding along the tract [].
is suggests that there might be other contributive factors
for tumour seeding along a percutaneous biopsy tract.
Seeding of tumour is when malignant cells are seen
growing along the path of a tract created by a needle usually
following diagnostic needling or a closed ablation procedure
F : High power view of the papillary renal cell carcinoma
seeding along the previous percutaneous biopsy tract.
and are highly site specic [,].isneedstobedistin-
guished from local recurrence, which is the development of
tumour at or in close proximity to the primary tumour usually
as a consequence of suboptimal treatment or microscopic
deposition of tumour cells in the surrounding tissue [,].
Diculties arise in histologically dierentiating the two when
a local recurrence incites a desmoplastic response to mimic a
healed needle track or when trying to identify a core tract on
sections that may not have been cut longitudinal to the axis
of the core. is leaves the delineation reliant on correlating
the site of the biopsy with the radiological images and
checking for tumour multifocality elsewhere in the tumour
bed. In one of the aforementioned cases, Giorgadze et al.
recognised the possibility that the retroperitoneal mass that
they found  years aer the biopsy could have been due
to recurrence rather than true seeding, given the presence
of lymphadenopathy []. In our case though, the presence
of tumour in fat is undoubtedly secondary to needle tract
seeding as it linearly follows the path of the needle (long and
narrow tract with radial extension from the long axis). In
addition to the cases in Tabl e , another case of cutaneous
seeding has also been reported aer biopsy of a pulmonary
metastatic deposit of RCC [], suggesting that the grade of
the tumour may also play a role in tract seeding. However,
several of the cases that have reported seeding in RCC,
including ours, have been low-grade papillary type which
is contrary to the suggestion that high grade tumours are
more likely to seed. A possible explanation of this is that
lower grade tumour cells can survive longer in the blood or
clot tract induced by the needle, due to its lower metabolic
requirements. Further studies are needed to investigate this.
In general terms, tract seeding will relate to the amount of
disruption of the tumour capsule (needle calibre and number
of punctures), pressure of egress at the puncture site (e.g.,
cystic masses or escaping haematoma), whether tumour cells
are dropped from the needle on its withdrawal (failure to
maintain negative pressure and burred needle tip), and the
ability of tumour cells to survive when deposited into a scar
for underrecognition of tract seeding unless the perinephric
fat is carefully histologically examined and the puncture site
is marked by the surgeon. Most pathologists, including those
Case Reports in Urology
at our institution, do a very thorough examination of the
that is standard practice. Seeding of tumour along a needle
of whether tumour tract seeding is underreported. is is
important in clinical practice because it has the potential to
upstage a tumour from a T to a T or T due to extension
into perinephric fat or into the abdominal wall and thus
potentially aect long-term survival.
Despite mixed reports about its diagnostic accuracy, the
practice of using percutaneous renal biopsies has increased
recently due to technological advances in imaging and
equipment used [].ishasledtoimprovementsinsafety
and decreased rates of complications further supporting its
use []. In this case, imaging results were consistent with a
papillary RCC and given the patient’s life expectancy of >
years, our recommendation was for him to have a partial
nephrectomy. However, the biopsy was done to overcome
management, which is highly invasive and not without risks.
e aim of this paper is not to deter surgeons from the use of
renal biopsy but to simply add another element to consider
prior to its use and to make a case for improved patient
of RCC seeding along a percutaneous biopsy tract. Whilst
this complication is so rare that it does not warrant a need
to cease 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,
the risk of this complication.
Conflict of Interests
e authors declare that there is no conict of interests
regarding the publication of this paper.
[] B. R. Herts and M. E. Baker, “e current role of percutaneous
biopsy in the evaluation of renal masses,Seminars in Urologic
percutaneous needle biopsy: the real story!,Clinical Radiology,
vol. , no. , pp. –, .
[] A. Volpe, J. R. Kachura, W. R. Geddie et al., “Techniques,
safety and accuracy of sampling of renal tumors by ne needle
aspiration and core biopsy,e Journal of Urology,vol.,no.
, pp. –, .
[] R.P.Gibbons,W.H.BushJr.,andL.L.Burnett,“Needletract
seeding following aspiration of renal cell carcinoma,Journal of
[] J. Auvert, C. C. Abbou, and V. Lavarenne, “Needle tract seeding
following puncture of renal oncocytoma,Progress in Clinical
and Biological Research, vol. , pp. –, .
[] G.C.Kiser,M.Totonchy,andJ.M.Barry,“Needletractseeding
aer percutaneous renal adenocarcinoma aspiration,Journal of
aspiration of a solid renal mass: tumor dissemination by renal
needle aspiration,Journal of Urology,vol.,no.,pp.
, .
[] P.D.Shenoy,B.N.Lakhkar,M.K.Ghosh,andU.D.Patil,“Cuta-
neous seeding of renal carcinoma by Chiba needle aspiration
biopsy. Case report,Acta Radiologica,vol.,no.,pp.,
[] T. Giorgadze, F. Qureshi, M. Aulicino, and S. M. Jacques,
“Retroperitoneal recurrence of a stage  renal cell carcinoma
four years following core biopsy and ne needle aspiration:
possible needle tract seeding,Diagnostic Cytopathology,vol.,
[] J. K. Mullins and R. Rodriguez, “Renal cell carcinoma seeding of
a percutaneous biopsy tract,Journal of the Canadian Urological
[] N. I. Sainani, S. Tatli, S. G. Anthony, P. B. Shyn, K. Tun-
cali, and S. G. Silverman, “Successful percutaneous radiologic
management of renal cell carcinoma tumor seeding caused
by percutaneous biopsy performed before ablation,Journal of
Vascular and Interventional Radiology,vol.,no.,pp.
, .
[] G.Jilani,D.Mohamed,H.Wadiaetal.,“Cutaneousmetastasis
of renal cell carcinoma through percutaneous ne needle
aspiration biopsy: case report,Dermatology Online Journal,vol.
, no. , article , .
[] R. Tyagi and P. Dey, “Needle tract seeding: an avoidable
complication,Diagnostic Cytopathology,vol.,no.,pp.
, .
Full-text available
We report a unique case for a 1.5 cm Chromophobe Renal Cell Carcinoma (ChRCC) tumor recurrence on the posterior abdominal wall along the renal tumor biopsy tract. This case presented on follow up at 4.5 years after radical nephrectomy T1bN0M0. Pathology was confirmed to be a chRCC with later excision of the mass. We believe the recurrence in this case is due to tumor seeding after multiple Renal Tumor biopsies (RTB) performed before surgery, as the tumor was located along the RTB tract.
Full-text available
The role of percutaneous tumour biopsies had gain importance in the management of renal cell carcinoma to provide diagnostic specimen for the patients with metastatic disease that could benefit a systemic treatment. Among the possible complications of this procedure, however, there is the risk of tumoral cells seeding along the biopsy’s tract; this complication, albeit being reported as anecdotal, could have devastating effects. Here we report a case of a young male who developed subcutaneous chest metastasis of renal cell carcinoma after a biopsy of a lung nodule. We subsequently reviewed other cases reported in literature
Full-text available
Background Percutaneous needle biopsy of renal masses has been increasingly utilized to aid the diagnosis and guide management. It is generally considered as a safe procedure. However, tumor seeding along the needle tract, one of the complications, theoretically poses potential risk of tumor spread by seeded malignant cells. Prior studies on the frequency of needle tract seeding in renal tumor biopsies are limited and clinical significance of biopsy-associated tumor seeding remains largely controversial. Methods Here we investigated the frequencies of biopsy needle tract tumor seeding at our institution by reviewing the histology of renal cell carcinoma nephrectomy specimens with a prior biopsy within the last seventeen years. Biopsy site changes were recognized as a combination of foreign body reaction, hemosiderin deposition, fibrosis and fat necrosis. The histologic evidence of needle tract tumor seeding was identified as clusters of tumor cells embedded in perinephric tissue spatially associated with the biopsy site. In addition, association between parameters of biopsy techniques and tumor seeding were investigated. Results We observed needle tract tumor seeding to perinephric tissue in six out of ninety-eight (6 %) renal cell carcinoma cases including clear cell renal cell carcinoma, papillary renal cell carcinoma, chromophobe, and clear cell papillary renal cell carcinoma. The needle tract tumor seeding was exclusively observed in papillary renal cell carcinomas (6/28, 21 %) that were unifocal, small-sized (≤ 4 cm), confined to the kidney and had type 1 features. No recurrence or metastasis was observed in the papillary renal cell carcinoma cases with tumor seeding or the stage-matched cases without tumor seeding. Conclusions Our study demonstrated a higher than reported frequency of needle tract tumor seeding. Effective communication between pathologists and clinicians as well as documentation of tumor seeding is recommended. Further studies with a larger patient cohort and longer follow up to evaluate the impact of needle tract tumor seeding on long term prognosis are needed. This may also help reach a consensus on appropriate pathologic staging of renal cell carcinoma when the only site of perinephric fat invasion is within a biopsy needle tract.
Neoplastic cell seeding due to needle tumor manipulation during renal mass biopsy (RMB) or thermal ablative treatment is a rare but potentially serious event that can turn an organ-confined and curable tumor in a nonorgan-confined and non-curable disease. Despite the widespread use of percutaneous thermal ablative treatment for small renal masses (SRMs), this complication has been described in few case reports and small case series and has never been reported after ablative treatment alone. We report a series of two patients that underwent cryoablation for SRMs and developed recurrence along the needle tract. Available knowledge on the controversial topic of tumor seeding following needle manipulation are poor. So far, reporting cases of tumor cell seeding due to needle manipulation is useful to permit a better understanding of this complication.
There are four reasons commonly offered by those opposed to the application of renal mass biopsy (RMB): (1) RMB is not useful because the lesion is almost certainly cancer; (2) RMB is not necessary because noninvasive techniques (i.e., cross-sectional imaging) are accurate enough to determine the risk of malignancy; (3) RMB is not safe; (4) RMB is not accurate. These are myths that can easily be debunked. There are three primary benefits to performing RMB: (1) RMB can help avoid intervention in cases of benign or nonaggressive tumor; (2) RMB may change the treatment plan if an unexpectedly aggressive renal malignancy is determined; (3) RMB might provide more assurance to both physician and patient regarding an active surveillance management plan. Overall, RMB should be considered in settings where this information would be useful, which is consistent with contemporary guidelines for the management of localized renal cancer. RMB is less useful in some patients at the extremes, such as an ill patient with a small renal mass where only an unusually aggressive malignancy would pose a threat or a patient with a long life expectancy and a larger renal mass where the lifetime risk of a missed malignancy is significant. In many patients, however, especially those aged 55–75 years and with masses 2–4 cm in size, RMB should be routinely offered.
More frequent utilization of cross-sectional imaging has led to an increase in the incidental diagnosis and a subsequent rise in incidence of small renal masses. Historical biases and technical limitations have prevented renal mass biopsy (RMB) from becoming a universal part of routine patient evaluation at the time of diagnosis of a renal mass. Nevertheless, more recently, RMB is being more commonly utilized and offers real-world utility in risk-stratifying patients and appropriately matching them with an optimal treatment strategy.
Usage of renal mass biopsy has increased in recent years, ranging from selected clinical scenarios to routine implementation in some institutions. Major tasks for the field of diagnostic histopathology include discriminating primary renal cell cancers from other tumors, especially metastases, hematolymphoid tumors, and urothelial carcinoma. Within primary renal cell neoplasms, relevant distinctions include recognizing clear cell papillary renal cell carcinoma, which despite its resemblance to clear cell cancer is nonaggressive, as well as discriminating oncocytoma from chromophobe carcinoma. Helpful immunohistochemical markers include PAX8 for verification of primary renal cell lineage and carbonic anhydrase IX for support of clear cell subtype. Cytokeratin 7 is generally considered the best marker for discriminating oncocytoma from chromophobe renal cell carcinoma, showing only rare positive cells in oncocytoma and greater staining in chromophobe carcinoma. For metastatic tumors, attempting to discriminate clear cell from non-clear cell types may be important for treatment selection.
A review and analysis of the literature demonstrates that needle track seeding in renal mass biopsy has been reported 16 times. This complication occurs almost exclusively among patients with papillary renal cell carcinoma. The incidence is associated with multiple punctures of the mass, the use of core needles of ≥20 gauge, and lack of a coaxial sheath. Needle tract seeding may be associated with tumor upstaging and a worse prognosis. Fine‐needle aspiration has a significantly lower rate of needle track seeding compared with large core needle biopsy (>20‐gauge needle). A more formalized risk‐based system for interpreting renal mass fine‐needle aspiration may be useful as clinicians choose among an increasing number of therapeutic options. Fine‐needle aspiration has a significantly lower rate of needle track seeding compared with large core (>20‐gauge) needle biopsy. A more formalized risk‐based system for interpreting renal mass fine‐needle aspiration specimens may be useful as clinicians choose among an increasing number of therapeutic options.
Full-text available
Cytodiagnosis of cutaneous metastasis of renal cell carcinoma (RCC) in the absence of history of primary tumor is difficult as it can be confused with other clear cell tumors. We report here a case of cytodiagnosis of cutaneous metastasis of RCC in a patient who had nephrectomy done 9 years back at some other centre, but did not have any records with him. Clinicians should be aware of the possibility of primary internal organ malignancy in patients presenting with cutaneous lesions and therefore conduct a careful examination and get necessary investigations. Prompt diagnosis and treatment will have its bearing on the eventual outcome.
Needle tract seeding refers to implantation of tumor cells by contamination when instruments like biopsy needles are used to examine, excise or ablate a tumor. Implantation along needle tract may lead to change of stage of the tumor, converting a resectable tumor into an inoperable one. In this paper we have reviewed the cases of needle tract seeding due to fine needle aspiration cytology (FNAC) procedure. We analyzed the various aspects of needle tract seedling and suggested how to take precautionary measures to prevent it. Diagn. Cytopathol. 2014. © 2014 Wiley Periodicals, Inc.
A case is reported of the successful image-based detection, diagnosis, and percutaneous ablation of tumor seeding in a 61-year-old man that was caused by percutaneous biopsy of a renal cell carcinoma performed before cryoablation and was not detected until 4 years after the biopsy procedure. Although tumor seeding is a rare complication after percutaneous biopsy or ablation, this case emphasizes the importance of imaging surveillance of the needle tract used during both biopsy and ablation procedures, provides guidance on measures that can be used to minimize the occurrence of tumor seeding, and demonstrates that entirely radiologic management can be successful.
We report the case of a 68-year-old male with extension of papillary renal cell carcinoma (Fuhrman grade III) along a percutanous biopsy tract detected at the time of partial nephrectomy. Biopsy was performed to a obtain tissue diagnosis of a complex renal cyst as the patient was unable to receive intravenous contrast for imaging due to a severe allergy. Although biopsy of indeterminate renal lesions can provide valuable diagnostic information, there are inherent risks associated with this procedure. The rare occurrence of tumour seeding should be considered when recommending percutaneous biopsy to a patient with a renal mass.
The demand for percutaneous needle biopsy is greater than ever before and with the majority of procedures requiring imaging guidance, radiologists have an increasingly important role in the diagnostic work-up of patients with suspected malignancy. All invasive procedures incur potential risks; therefore, clinicians should be aware of the most frequently encountered complications and have a realistic idea of their likelihood. Tumour seeding, whereby malignant cells are deposited along the tract of a biopsy needle, can have disastrous consequences particularly in patients who are organ transplant candidates or in those who would otherwise expect good long-term survival. Fortunately, tumour seeding is a rare occurrence, yet the issue invariably receives a high profile and is often regarded as a major contraindication to certain biopsy procedures. Although its existence is in no doubt, realistic insight into its likelihood across the spectrum of biopsy procedures and multiple anatomical sites is required to permit accurate patient counselling and risk stratification. This review provides a comprehensive overview of tumour seeding and examines the likelihood of this much feared complication across the range of commonly performed diagnostic biopsy procedures. Conclusions have been derived from an extensive analysis of the published literature, and a number of key recommendations should assist practitioners in their everyday practice.
A 39-year-old man, who had undergone left nephrectomy for renal cell carcinoma of clear cell type, was noted to have a solitary nodular shadow in the right lung on chest X-ray. Percutaneous needle biopsy of the lung was performed via the right anterior chest wall and the histologic findings showed metastasis from renal carcinoma. Six month later, the patient presented with a cutaneous nodule at the site of puncture of the lung needle biopsy. Histological examination of a biopsy of the skin tumor revealed features of metastatic renal cell carcinoma of clear cell type. Surgical excision of the cutaneous nodule was performed, followed by radiotherapy at the site of the skin lesion on the chest wall. After treatment, the patient remains disease free after one year of follow-up. This case represents an unusual clinical presentation of metastatic renal cell carcinoma that appears to have been translocated to the skin by the needle biopsy.
A case of tumor implantation along the needle tract 20 months after needle aspiration of a renal cell carcinoma is reported. This rare but possible complication of needle aspiration should not discourage its use in the evaluation of renal mass lesions. Needle aspiration should be reserved for those patients in whom the clinical findings, roentgenograms and sonography indicate a benign process (that is to confirm that the mass is benign).
Fine needle aspiration biopsy yields a high rate of positive tissue with negligible local sequelae. We report the first instance known to us of Chiba needle tract seeding following this biopsy technique in a patient with renal malignancy.
We report a case of tumor dissemination via needle aspiration of a solid hypovascular renal mass. This case emphasizes how needle aspiration of these masses does not always lead to proper management and may be detrimental to the patient.