How should small renal masses be treated?
Small renal masses pose a management dilemma, since they include both renal cancers and other benign tumours (upto 50%, depending on size). Biopsy of the lesion may help decision-making, but can suffer from sampling error and difficulty in histologic interpretation. For young and healthy patients, excision of the mass is usually preferred, and if possible, should be done in a nephron-sparing procedure (i.e. partial nephrectomy). Not all renal masses are amenable to partial nephrectomy, and of those which are, many may require an open approach. Laparoscopic partial nephrectomy is becoming more widely available and applicable, but remains a challenging surgical procedure. Laparoscopic radical nephrectomy is the gold-standard for treatment of renal cancer, but results in over-treatment and loss of a renal unit if the mass is benign. For the elderly or infirm patient, a small renal mass may not pose a significant threat, and as such, may be safely kept under surveillance. If treatment is r
