scholarly journals The Past, Present, and Future in Management of Small Renal Masses

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Sarah C. Ha ◽  
Haley A. Zlomke ◽  
Nicholas Cost ◽  
Shandra Wilson
Keyword(s):  
Renal Mass ◽  
Treatment Modalities ◽  
Small Renal Mass ◽  
Consensus Guidelines ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Cross Sectional ◽  
The Past ◽  
Cross Sectional Imaging ◽  
Ablative Techniques

Management of small renal masses (SRMs) is currently evolving due to the increased incidence given the ubiquity of cross-sectional imaging. Diagnosing a mass in the early stages theoretically allows for high rates of cure but simultaneously risks overtreatment. New consensus guidelines and treatment modalities are changing frequently. The multitude of information currently available shall be summarized in this review. This summary will detail the historic surgical treatment of renal cell carcinoma with current innovations, the feasibility and utility of biopsy, the efficacy of ablative techniques, active surveillance, and use of biomarkers. We evaluate how technology may be used in approaching the small renal mass in order to decrease morbidity, while keeping rates of overtreatment to a minimum.

The aetiology, epidemiology, clinical features, and investigation of kidney cancer

2017 ◽  
Author(s):  
Nilay Patel ◽  
David Cranston ◽  
Mark Sullivan
Keyword(s):  
Renal Cancer ◽  
Mortality Rates ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Cross Sectional ◽  
The Past ◽  
Urological Malignancies ◽  
Number Of Patients ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Over 270,000 patients worldwide are diagnosed with renal cancer every year. It is the most lethal of all urological malignancies, with 33–44% of patients dying as a result of the disease. The past three decades has seen the incidence of renal cancer increasing by approximately 2% per year. This increased incidence has predominantly been within localized tumours, detected incidentally due to the increased use of cross-sectional imaging in medical practice. Despite an increase in the number of patients undergoing surgery for renal cancer, mortality rates have continued to rise. There is some evidence to suggest this may be a consequence of the overdiagnosis and overtreatment of small renal masses. At present, there is no justification for national screening programmes for renal cancer.

scholarly journals Small Renal Mass with Sarcomatoid Features

2020 ◽  
Vol 14 (1) ◽  
pp. 54-56
Author(s):  
Anthony D. Oberle ◽  
James A. Brown
Keyword(s):  
Renal Cell Carcinoma ◽  
Renal Mass ◽  
Small Renal Mass ◽  
Common Pathway ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Threshold Size ◽  
Sarcomatoid Renal Cell Carcinoma ◽  
Worse Prognosis ◽  
Sarcomatoid Differentiation

Interest in surveillance for small renal masses has expanded exponentially due to incidental detection with increased imaging. However, some of these small renal masses behave aggressively. Sarcomatoid pathology is associated with a worse prognosis. Traditionally, it has been thought of as a common pathway of dedifferentiation once a renal malignancy of any histology reaches a threshold size of approximately 3 cm. We report a case of a 65-year-old male with a 2 cm sarcomatoid renal cell carcinoma. To our knowledge, this is the smallest tumor with sarcomatoid differentiation reported in the literature.

Management of Small Renal Masses

2018 ◽  
Author(s):  
Keith A Lawson ◽  
Antonio Finelli
Keyword(s):  
Natural History ◽  
Renal Mass ◽  
The Body ◽  
Renal Tumors ◽  
Small Renal Mass ◽  
Small Renal Masses ◽  
Tumor Biopsy ◽  
Renal Masses ◽  
History Of

The rise in incidentally discovered enhancing solid renal tumors has spurred the development of new approaches to managing this unique clinical entity known as the small renal mass (SRM). These approaches are grounded on a better understanding of the natural history of SRM, with the goal to reduce the morbidity associated with their management and avoid overtreatment. In this chapter, we review the body of evidence pertaining to the classification and clinical management of SRMs with respect to diagnosis, treatment, and follow-up. In addition, we discuss the controversies and active areas of development for this rapidly evolving field that strides towards a precision medicine paradigm.  This review contains 6 figures, 6 tables and 63 references Keywords: Small renal mass, renal cell carcinoma, radical nephrectomy, renal tumor biopsy, active surveillance, natural history, oncocytoma, robotic surgery, partial nephrectomy

scholarly journals Radiologic Evaluation of Small Renal Masses (I): Pretreatment Management

2008 ◽  
Vol 2008 ◽  
pp. 1-16 ◽  
Author(s):  
A. Marhuenda ◽  
M. I. Martín ◽  
C. Deltoro ◽  
J. Santos ◽  
Jose Rubio Briones
Keyword(s):  
Renal Mass ◽  
Relevant Literature ◽  
Main Question ◽  
Small Renal Mass ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Detailed Review ◽  
Radiologic Evaluation ◽  
Followup Studies ◽  
Ct And Mri

When characterizing a small renal mass (SRM), the main question to be answered is whether the mass represents a surgical or nonsurgical lesion or, in some cases, if followup studies are a reasonable option. Is this a task for a urologist or a radiologist? It is obvious that in the increasing clinical scenario where this decision has to be made, both specialists ought to work together. This paper will focus on the principles, indications, and limitations of ultrasound, CT, and MRI to characterize an SRM in 2008 with a detailed review of relevant literature. Special emphasis has been placed on aspects regarding the bidirectional information between radiologists and urologists needed to achieve the best radiological approach to an SRM.

scholarly journals A comparative study of ultrasound and cross-sectional imaging for detection of small renal masses: anatomic factors and radiologist's experience

2020 ◽  
Vol 18 ◽  
Author(s):  
Fernando Ide Yamauchi ◽  
Omir Antunes Paiva ◽  
Thaís Caldara Mussi ◽  
Miguel José Francisco ◽  
Ronaldo Hueb Baroni
Keyword(s):  
Comparative Study ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Management of Small Renal Masses

2018 ◽  
Author(s):  
Keith A Lawson ◽  
Antonio Finelli
Keyword(s):  
Natural History ◽  
Renal Mass ◽  
The Body ◽  
Renal Tumors ◽  
Small Renal Mass ◽  
Small Renal Masses ◽  
Tumor Biopsy ◽  
Renal Masses ◽  
History Of

The rise in incidentally discovered enhancing solid renal tumors has spurred the development of new approaches to managing this unique clinical entity known as the small renal mass (SRM). These approaches are grounded on a better understanding of the natural history of SRM, with the goal to reduce the morbidity associated with their management and avoid overtreatment. In this chapter, we review the body of evidence pertaining to the classification and clinical management of SRMs with respect to diagnosis, treatment, and follow-up. In addition, we discuss the controversies and active areas of development for this rapidly evolving field that strides towards a precision medicine paradigm.  This review contains 6 figures, 6 tables and 63 references Keywords: Small renal mass, renal cell carcinoma, radical nephrectomy, renal tumor biopsy, active surveillance, natural history, oncocytoma, robotic surgery, partial nephrectomy

scholarly journals Extensive renal infarction following percutaneous biopsy of a small renal mass: A case report

2013 ◽  
Vol 7 (1-2) ◽  
pp. 118
Author(s):  
Samuel Abourbih ◽  
Saad Aldousari ◽  
Fadi Brimo ◽  
Atilla Omeroglu ◽  
Wassim Kassouf
Keyword(s):  
Renal Mass ◽  
Laryngeal Squamous Cell Carcinoma ◽  
Percutaneous Biopsy ◽  
Renal Infarction ◽  
Small Renal Mass ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Percutaneous Renal Biopsy ◽  
Nephron Sparing ◽  
Solid Renal Mass

Percutaneous renal biopsy has become increasingly utilized particularly in patients undergoing active surveillance for small renal masses. We present a case of a significant complication following biopsy of a solid renal mass in a patient who was recently diagnosed with laryngeal squamous cell carcinoma. The patient was planned for nephron sparing surgery that was converted to radical nephrectomy due to extensive renal infarction secondary to significant subcapsular hemorrhage inflicted by the biopsy.

scholarly journals Small Renal Mass Biopsy: When to Do?

2021 ◽  
Vol 19 (3) ◽  
pp. 129-135
Author(s):  
Jin Seon Cho
Keyword(s):  
Risk Stratification ◽  
Renal Mass ◽  
Treatment Options ◽  
Benign Tumors ◽  
Small Renal Mass ◽  
Tumor Biopsy ◽  
Cross Sectional ◽  
Surgical Specimen ◽  
Improve Risk Stratification ◽  
Cross Sectional Imaging

The incidence of small renal mass (SRM) is increasing largely owing to the growing use of cross-sectional imaging. About 20% of SRMs are benign, and smaller masses are likely to have pathological characteristics of low malignant potential. Determining the optimal management for SRM can be challenging. Advances in our understanding of the nature of SRMs and expanding treatment options for SRMs have stimulated interest in SRM biopsy which can facilitate risk stratification and prognostication. Continuing concern regarding complications and accuracy, SRM biopsy is underutilized. However, recent series on SRM biopsy have reported diagnostic accuracy and rare complications. The median concordance rate between tumor histotype on renal tumor biopsy and on the surgical specimen was over 90%. SRM biopsy can be selectively used to improve risk stratification in patient where the clinical management may change on the basis of the results of biopsy. Currently, SRM biopsy can be recommended in most cases except in patients who have imaging or clinical characteristics indicative of benign tumors and in cases in which conservative management is considered. Urologists should be aware of the benefits of SRM biopsy which should be discussed with patients.

scholarly journals The Natural History and Predictors for Intervention in Patients with Small Renal Mass Undergoing Active Surveillance

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Zaher Bahouth ◽  
Sarel Halachmi ◽  
Gil Meyer ◽  
Ofir Avitan ◽  
Boaz Moskovitz ◽  
...  
Keyword(s):  
Natural History ◽  
Active Surveillance ◽  
Renal Mass ◽  
Nephron Sparing Surgery ◽  
Small Renal Mass ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Nephron Sparing ◽  
The Mean

Aim. To describe the natural history of small renal mass on active surveillance and identify parameters that could help in predicting the need for intervention in patients with small renal masses undergoing active surveillance. We also discuss the need for renal biopsy in the management of these patients.Methods. A retrospective analysis of 78 renal masses ≤4 cm diagnosed at our Urology Department at Bnai Zion Medical Center between September 2003 and March 2012.Results. Seventy patients with 78 small renal masses were analyzed. The mean age at diagnosis was 68 years (47–89). The mean follow-up period was 34 months (12–112). In 54 of 78 masses there was a growth of at least 2 mm between imaging on last available follow-up and diagnosis. Eight of the 54 (15%) masses which grew in size underwent a nephron-sparing surgery, of which two were oncocytomas and six were renal cell carcinoma. Growth rate and mass diameter on diagnosis were significantly greater in the group of patients who underwent a surgery.Conclusions. Small renal masses might eventually be managed by active surveillance without compromising survival or surgical approach. All masses that were eventually excised underwent a nephron-sparing surgery. None of the patients developed metastases.

scholarly journals Trends in the Management of Small Renal Masses: A Survey of Members of the Endourological Society

2017 ◽  
Vol 4 (3) ◽  
pp. 10-19 ◽  
Author(s):  
Anand Mohapatra ◽  
Aaron Potretzke ◽  
John Weaver ◽  
Barrett Anderson ◽  
Joel Vetter ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Partial Nephrectomy ◽  
Radical Nephrectomy ◽  
Treatment Modalities ◽  
Percutaneous Ablation ◽  
Robotic Partial Nephrectomy ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Open Partial Nephrectomy ◽  
The Past

Treatment modalities for small renal masses (SRMs) include open or minimally invasive radical or partial nephrectomy, and laparoscopic or percutaneous ablations. Members of the Endourological Society were surveyed to evaluate how practitioner and clinical practice characteristics may be associated with the management of SRMs over time. The survey assessed characteristics of urologists (recency of residency and fellowship training, clinical practice type and location, and treatment modalities available) and their management of SRMs over the past year and over the course of the year 5 years prior. Of the 1495 surveys e-mailed, there were 129 respondents (8.6%). Comparing the past year to 5 years prior, there was increasing utilization of robotic partial nephrectomy (p < 0.001) and robotic radial nephrectomy (p = 0.031). In contrast, there was decreasing utilization of open partial nephrectomy (p < 0.001), open radical nephrectomy (p = 0.039), laparoscopic partial nephrectomy (p = 0.002), and laparoscopic radical nephrectomy (p = 0.041). Employment of laparoscopic ablation decreased (p = 0.001), but that of percutaneous ablation did not change significantly. For masses treated with image-guided therapy, there was increasing utilization of microwave ablation (p = 0.008) and decreasing usage of radiofrequency ablation (p = 0.002). Future studies should focus on the most effective treatment modalities based on provider, patient, and tumor characteristics.

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