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Incidentally detected small renal masses - investigation and management.
MedLine Citation:
PMID:  22003479     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background With increasing use of imaging to diagnose other conditions, incidentally detected small renal masses and cysts are now a common clinical scenario for both the general practitioner and the urologist. Objective This article outlines a diagnostic and management approach to the incidental finding of a small renal mass or cyst. Discussion Renal cell carcinoma represent 2-3% of all cancers and more than 50% of these are detected incidentally. Small renal masses are defined as renal masses less than 4 cm in diameter. They comprise a heterogeneous group of lesions; 20% are benign and only 20-25% prove to be potentially aggressive kidney cancers at the time of diagnosis. Work-up involves a full history, looking for evidence of paraneoplastic syndromes and examination, which is usually normal. Recommended blood tests include basic biochemistry and haematology, and imaging. A four phase contrasted computerised tomography scan of the kidneys allows a detailed examination of each aspect of the functional anatomy of the kidney, which can help approximate risk of malignancy and direct management. Not all patients with small renal masses require a biopsy. However, biopsy is required in patients who opt for active surveillance or ablative therapy. Management options include surveillance, surgery and ablative techniques.
Authors:
Kantha Rao; Peter L Royce
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Australian family physician     Volume:  40     ISSN:  0300-8495     ISO Abbreviation:  Aust Fam Physician     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0326701     Medline TA:  Aust Fam Physician     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  776-82     Citation Subset:  IM    
Affiliation:
MBBS(Malaysia), MS(Malaysia), FRCS(Urol), is Urology Fellow, Department of Urology, Alfred Hospital, Melbourne, Victoria and a urologist, Kuala Lumpur Hospital, Malaysia.
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