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A Practical Review of the Diagnosis and Management of Small Renal Masses

Stanley A. Yap,1 Shabbir M.H. Alibhai,2,3Antonio Finelli,1
1Division of Urologic Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada. 2Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada. 3Department of Medicine, University of Toronto, Toronto, ON, Canada.


Abstract
The incidence of small renal masses (SRMs) has risen steadily over time, and SRMs now represent the majority of newly diagnosed renal lesions. Approximately 80% of newly diagnosed SRMs will be malignant. However, identifying a benign versus malignant lesion non-invasively can be difficult since no distinct imaging characteristics or growth patterns exist between the two. We have witnessed concurrent improvements in treatment strategies for small, localized tumors and have gained a better understanding of their natural history. Along with these changes there has been a shift in the manner in which we diagnose and treat SRMs. Although surgery remains the standard of care, we can now offer a variety of therapies individualized to the patient.
Keywords: kidney cancer, small renal mass, diagnosis, treatment.