BERKELEY, CA (UroToday.com) - The detection of incidental renal masses is increasingly more common with more widespread use of cross-sectional abdominal imaging studies.

Over an 8 year period, 143 patients underwent partial nephrectomy. Of these, 23 (16.1%) revealed benign pathology, including 10 angiomyolipomas, 8 oncocytomas, 3 cysts, 1 mesoblastic nephroma, and 1 metanephric adenoma. All were called "suspicious for renal cell carcinoma" by experienced radiologists on preoperative imaging. Mean patient age was 59 years, and mean tumor size was 2.5 cm (range 0.6-8 cm). Furthermore, the authors found no correlation between tumor size and incidence of benign pathology, with 15.9% of tumors < 2 cm, 16.5% of tumors 2-4 cm, and 14.3% of tumors > 4 cm demonstrating benign pathology.

The authors conclude that there is no reliable indicator of benign pathology preoperatively in solitary renal masses, as all of these were considered to be renal cell carcinoma on preoperative imaging. Overall, management of these tumors should favor parenchymal sparing approaches that can be both diagnostic and therapeutic, while preserving functional renal mass.

Kutikov A, Fossett LK, Ramchandani P, Tomaszewski JE, Siegelman ES, Banner MP, Van Arsdalen KN, Wein AJ, Malkowicz SB

Urology 68(4): 737-740, 2006.

UroToday.com Renal Cancer Section

Written by Christopher G. Wood, MD, a Contributing Editor with UroToday.

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