Related Experiment Video
Updated: Dec 18, 2025
In Vivo, Percutaneous, Needle Based, Optical Coherence Tomography of Renal Masses
Published on: March 30, 2015
Management of the Small Renal Mass: a 2020 Update
Rand N Wilcox Vanden Berg1, Spyridon P Basourakos1, Samuel LaRussa2,3
1Department of Urology, Weill Cornell Medicine/New York Presbyterian, New York, NY, USA.
Purpose Of Review:
Small renal masses (≤ cT1a, less than 4 cm) are a subset of renal tumors with low malignant and metastatic potential but increasing incidence given increased use of cross-sectional imaging. Here, we review the diagnostic and treatment options available for the lesions.
Recent Findings:
While the low metastatic potential of SRMs has been known, recent studies show that 30% of SRMs removed surgically are benign. Renal biopsy is a tool that can be implemented to help with diagnosis before treatment (options of which include active surveillance, ablation, and surgery). Active surveillance might be associated with worse cancer-specific survival but all interventional methods appear to fare similarly. Advancements have also been made in percutaneous ablation techniques, and they now are included on multiple guideline statements. Active surveillance, surgery (PN and RN), and thermal ablation are all treatment options for SRMs with similar outcomes but varying side effects.
Insights
Small renal masses (SRMs) are increasingly detected. Biopsies aid diagnosis, and while active surveillance has risks, treatments like ablation and surgery offer similar outcomes for these low-malignancy tumors.
Area of Science:
- Urology
- Oncology
- Diagnostic Imaging
Background:
- Small renal masses (SRMs), defined as tumors ≤ cT1a (less than 4 cm), are increasingly diagnosed due to advances in cross-sectional imaging.
- SRMs have a low potential for malignancy and metastasis, yet a significant proportion are found to be benign upon surgical removal.
Purpose of the Study:
- To review current diagnostic and treatment strategies for small renal masses.
- To evaluate the efficacy and outcomes of various management options for SRMs.
Main Methods:
- Review of diagnostic tools, including renal biopsy, for characterizing SRMs.
- Analysis of treatment modalities such as active surveillance, surgical intervention (partial nephrectomy and radical nephrectomy), and percutaneous ablation techniques.
Main Results:
- Renal biopsy can assist in pre-treatment diagnosis, potentially avoiding unnecessary interventions.
- Active surveillance may be linked to poorer cancer-specific survival, but interventional methods (surgery and ablation) demonstrate comparable outcomes.
- Percutaneous ablation techniques have advanced and are now recognized in clinical guidelines.
Conclusions:
- Accurate diagnosis of SRMs is crucial, with renal biopsy playing a key role.
- Active surveillance, surgery, and thermal ablation are viable treatment options for SRMs, each with distinct side effect profiles but similar overall outcomes.
More Related Videos
Related Concept Videos
01:30Urinary Tract Calculi III: Medical Management
01:28Chronic Kidney Disease III: Interprofessional Care
01:25Urinary Tract Calculi VI: Surgical Management
01:26Nephrotic Syndrome II : Assessment and Medical Management
01:28Urinary Tract Calculi V: Nursing Management
01:16Kidney Transplant III: Nursing Management