Table 4.

Clinical scenarios where an SRM biopsy may be helpful

Prior to/during active surveillance, if the patient is a candidate for later active therapy	Where a patient is unsure whether to pursue definitive treatment
Prior to ablation	Patients with chronic kidney disease
Synchronous tumours to assess for genetic or syndromic aetiologies	Suspected metastases (particularly lymphoma) or an inflammatory mass where a diagnosis has not otherwise been achieved
Young patients with small lesions—may be benign	A central infiltrating lesion where a transitional cell carcinoma is possible on imaging and only if urine cytological and endoscopic assessment have been unsuccessful

SRM, small renal mass.