Optimal Management of Small Renal Masses

Abstract

The incidence of small renal masses is increasing. Limited data suggest that although most are malignant, they are also likely to show indolent behavior. The tendency of these tumors to occur in older patient populations with multiple comorbidities raises important issues. Retrospective and prospective studies suggest that a substantial proportion of these small renal masses can be observed without compromising the opportunity for cure or subjecting patients to invasive procedures that might impact negatively on quality of life. Less-invasive treatment modalities, including partial nephrectomy and energy ablation techniques, provide multiple options for some patients. This article reviews selected aspects of the management of small renal masses, including their natural history, imaging, diagnostic biopsies, and treatment options.

Real‐time virtual ultrasonographic radiofrequency ablation of renal cell carcinoma

“…RVS is also useful for treating lesions that cannot be visualized on US but are apparent on CT. A lesion detected by RVS can readily be placed by conventional US using the surrounding anatomical relationships. Furthermore, RVS is useful in RFA [18,19]; as lesions after RFA show a very irregular area, and target lesions can be difficult to identify, treatment is often complicated by the need for additional sessions after the initial session of RFA. Such lesions can reportedly be treated using contrast‐enhanced US [20–23], but this method is very difficult and not all lesions are contrast‐enhanced.…”