Open Access

ARTICLE

Current management of small renal masses

Michelle L. Ramírez, Christopher P. Evans

Department of Urology and Cancer Center, University of California at Davis, Sacramento, California, USA
Address correspondence to Dr. Christopher P. Evans, Department of Urology, 4860 Y St., Suite 3500, University of California, Davis Medical Center, Sacramento, CA 95817 USA

Canadian Journal of Urology 2007, 14(Suppl.6), 39-47.

Abstract

The incidence of small renal masses (< 4 cm) is increasing due to the widespread use of imaging studies. Many of these incidental lesions may remain asymptomatic or in fact be benign, and recent insight into their natural course has contributed to modifications in management. With improvements in biopsy technique and minimally invasive technologies, appropriate diagnosis and treatment of these masses are further being evaluated. Other contemporary approaches, including surveillance, laparoscopic partial nephrectomy, enucleation, ablative procedures, and high-intensity focused ultrasound, are weighed against open nephron-sparing surgery, the current gold standard for treatment. Here, we review currently available data on the efficacy of these treatment options. Additionally, we examine the natural history of small renal masses, the role of diagnostic biopsy, and follow-up strategies for proper management.

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