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Head and Neck Cancer: United Kingdom National Multidisciplinary Guidelines, Sixth Edition
- Jarrod J Homer, Stuart C Winter, Elizabeth C Abbey, Hiba Aga, Reshma Agrawal, Derfel ap Dafydd, Takhar Arunjit, Patrick Axon, Eleanor Aynsley, Izhar N Bagwan, Arun Batra, Donna Begg, Jonathan M Bernstein, Guy Betts, Colin Bicknell, Brian Bisase, Grainne C Brady, Peter Brennan, Aina Brunet, Val Bryant, Linda Cantwell, Ashish Chandra, Preetha Chengot, Melvin L K Chua, Peter Clarke, Gemma Clunie, Margaret Coffey, Clare Conlon, David I Conway, Florence Cook, Matthew R Cooper, Declan Costello, Ben Cosway, Neil J A Cozens, Grant Creaney, Daljit K Gahir, Stephen Damato, Joe Davies, Katharine S Davies, Alina D Dragan, Yong Du, Mark R D Edmond, Stefano Fedele, Harriet Finze, Jason C Fleming, Bernadette H Foran, Beth Fordham, Mohammed M A S Foridi, Lesley Freeman, Katherine E Frew, Pallavi Gaitonde, Victoria Gallyer, Fraser W Gibb, Sinclair M Gore, Mark Gormley, Roganie Govender, J Greedy, Teresa Guerrero Urbano, Dorothy Gujral, David W Hamilton, John C Hardman, Kevin Harrington, Samantha Holmes, Jarrod J Homer, Deborah Howland, Gerald Humphris, Keith D Hunter, Kate Ingarfield, Richard Irving, Kristina Isand, Yatin Jain, Sachin Jauhar, Sarra Jawad, Glyndwr W Jenkins, Anastasios Kanatas, Stephen Keohane, Cyrus J Kerawala, William Keys, Emma V King, Anthony Kong, Fiona Lalloo, Kirsten Laws, Samuel C Leong, Shane Lester, Miles Levy, Ken Lingley, Gitta Madani, Navin Mani, Paolo L Matteucci, Catriona R Mayland, James McCaul, Lorna K McCaul, Pádraig McDonnell, Andrew McPartlin, Valeria Mercadante, Zoe Merchant, Radu Mihai, Mufaddal T Moonim, John Moore, Paul Nankivell, Sonali Natu, A Nelson, Pablo Nenclares, Kate Newbold, Carrie Newland, Ailsa J Nicol, Iain J Nixon, Rupert Obholzer, James T O'Hara, S Orr, Vinidh Paleri, James Palmer, Rachel S Parry, Claire Paterson, Gillian Patterson, Joanne M Patterson, Miranda Payne, L Pearson, David N Poller, Jonathan Pollock, Stephen Ross Porter, Matthew Potter, Robin J D Prestwich, Ruth Price, Mani Ragbir, Meena S Ranka, Max Robinson, Justin W G Roe, Tom Roques, Aleix Rovira, Sajid Sainuddin, I J Salmon, Ann Sandison, Andy Scarsbrook, Andrew G Schache, A Scott, Diane Sellstrom, Cherith J Semple, Jagrit Shah, Praveen Sharma, Richard J Shaw, Somiah Siddiq, Priyamal Silva, Ricard Simo, Rabin P Singh, Maria Smith, Rebekah Smith, Toby Oliver Smith, Sanjai Sood, Francis W Stafford, Neil Steven, Kay Stewart, Lisa Stoner, Steve Sweeney, Andrew Sykes, Carly L Taylor, Selvam Thavaraj, David J Thomson, Jane Thornton, Neil S Tolley, Nancy Turnbull, Sriram Vaidyanathan, Leandros Vassiliou, John Waas, Kelly Wade-McBane, Donna Wakefield, Amy Ward, Laura Warner, Laura-Jayne Watson, H Watts, Christina Wilson, Stuart C Winter, Winson Wong, Chui-Yan Yip, Kent Yip
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- Journal:
- The Journal of Laryngology & Otology / Volume 138 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 14 March 2024, pp. S1-S224
- Print publication:
- April 2024
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- Article
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6 - The case for biopsy in the modern management of renal cancer
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- By Colin P. Cantwell, Division of Abdominal Imaging and Interventional Radiology, Department of Radiology and Harvard Medical School, Massachusetts, General Hospital, Boston, USA, Debra Gervais, Division of Abdominal Imaging and Interventional Radiology, Department of Radiology and Harvard Medical School, Massachusetts, General Hospital, Boston, USA, Peter R. Mueller, Division of Abdominal Imaging and Interventional Radiology, Department of Radiology and Harvard Medical School, Massachusetts, General Hospital, Boston, USA
- Edited by Uday Patel, St George's Hospital, London
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- Book:
- Carcinoma of the Kidney
- Published online:
- 08 August 2009
- Print publication:
- 06 December 2007, pp 112-125
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Summary
Introduction
In the past, focal renal biopsy had a limited role in the management of renal masses. Potential complications and an overestimated risk of seeding the biopsy tract dissuaded operators from biopsy, and when performed definitive results were uncommon. Hence, urologists presumed that solid renal lesions over 3 cm and complex cysts were predominantly renal cell carcinomas (RCC) and rarely performed biopsy before surgical procedures.
Attitudes have changed to renal biopsy for a number of reasons, firstly, histological techniques have become more reliable. The morphology, immunocytochemical, and genetic profiles of RCC and its subtypes have been better described. Immunohistochemistry and special stains and genetic test are available to help differentiate tumor subtypes. Oncocytoma, oncocytic cancers, RCC and fat poor angiomyolipomas (AML) can now be differentiated histologically. There has also been a downward-stage migration of renal tumors at diagnosis and a substantial fraction of contemporary solid renal masses are benign. In one study, 12.8% of solid renal masses were found to be benign. When stratified by size, the proportion of benign masses was 25% for masses smaller than 3 cm, 30% for masses smaller than 2 cm, and 44% for masses smaller than 1 cm. Furthermore, small solid benign renal masses cannot be reliably distinguished from malignant masses by means of imaging findings alone.