Skip to main content

Small Renal Neoplasms

  • Chapter
  • 946 Accesses

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

13.9 Conclusion

Radiologists frequently encounter small renal masses in daily practice. Most are small benign cysts which are difficult to characterize because of their size. With modern cross-sectional imaging techniques, however, it is possible to distinguish most of these from true renal neoplasms. The small renal neoplasms that contain fat or reside within the collecting system of the kidney are easily identified and managed appropriately. The remainder of enhancing, small solid renal masses continue to be a challenge. Since their histologic make-up and biologic behavior cannot be accurately predicted by imaging, a choice of nephron-sparing surgical or percutaneous ablation techniques vs “watchful waiting” are rational options for management. The appropriate course of action depends heavily on individual patient factors.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   299.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Abdulla C, Kalra MK, Saini S et al. (2002) Pseudoenhancement of simulated renal cysts in a phantom using different multidetector CT scanners. Am J Roentgenol 179:1473–1476

    Google Scholar 

  • Aizawa S, Suzuki M, Kikuchi Y et al. (1987) Clinicopathological study on small renal cell carcinomas with metastases. Acta Pathol Jpn 37:947–954

    PubMed  CAS  Google Scholar 

  • Amendola MA, Bree RL, Pollack HM et al. (1988) Small renal cell carcinomas: resolving a diagnostic dilemma. Radiology 166:637–641

    PubMed  CAS  Google Scholar 

  • Bae KT, Heiken JP, Siegel CL et al. (2000) Renal cysts: Is attenuation artifactually increased on contrast-enhanced CT images? Radiology 216:792–796

    PubMed  CAS  Google Scholar 

  • Bell ET (ed) (1950) Tumors of the kidney. In: Renal diseases. Lea and Febiger, Philadelphia

    Google Scholar 

  • Bennington JL (1973) Cancer of the kidney: etiology, epidemiology, and pathology. Cancer 32:1017–1029

    PubMed  CAS  Google Scholar 

  • Bennington JL (1987) Renal adenoma. World J Urol 5:66–70

    Article  Google Scholar 

  • Birnbaum BA, Maki DD, Chakraborty DP et al. (2002) Renal cyst pseudoenhancement evaluation with an anthropomorphic body CT phantom. Radiology 225:83–90

    PubMed  Google Scholar 

  • Black WC, Ling A (1990) Is earlier diagnosis really better? The misleading effects of lead time and length time biases. Am J Roentgenol 155:625–630

    CAS  Google Scholar 

  • Bosniak MA (1995) Observation of small incidentally detected renal masses. Semin Urol Oncol 13:267–272

    PubMed  CAS  Google Scholar 

  • Bosniak MA, Rofsky NM (1996) Problems in the detection and characterization of small renal masses. Radiology 198:638–641

    PubMed  CAS  Google Scholar 

  • Bosniak MA, Birnbaum BA, Krinsky GA et al. (1995) Small renal parenchymal neoplasms: further observations on growth. Radiology 197:589–597

    PubMed  CAS  Google Scholar 

  • Campbell SC, Novick AC, Herts B et al. (1997) Prospective evaluation of fine needle aspiration of small, solid renal masses: accuracy and morbidity. Urology 50:25–29

    Article  PubMed  CAS  Google Scholar 

  • Curry NS (1995) Small renal masses (lesions smaller than 3 cm): imaging evaluation and management. Am J Roentgenol 164:355–362

    CAS  Google Scholar 

  • Curry NS (2002) Imaging the small solid renal mass. Abdom Imaging 27:629–636

    Article  PubMed  CAS  Google Scholar 

  • Curry NS, Schabel, SI, Betsill WL (1986) Small renal neoplasms: diagnostic imaging, pathologic features, and clinical course. Radiology 158:113–117

    PubMed  CAS  Google Scholar 

  • Dechet CB, Sebo T, Farrow G et al. (1999) Prospective analysis of intraoperative frozen needle biopsy of solid renal masses in adults. J Urol 162:1282–1285

    Article  PubMed  CAS  Google Scholar 

  • Ellis WJ, Bauer KD, Oyasu R et al. (1992) Flow cytometric analysis of small renal tumors. J Urol 148:1774–1777

    PubMed  CAS  Google Scholar 

  • Eschwege P, Saussine C, Steichen B et al. (1996) Radical nephrectomy for renal cell carcinoma 30 mm or less: longterm follow-up results. J Urol 155:1196–1199

    PubMed  CAS  Google Scholar 

  • Fielding JR, Visweswaran A, Silverman S et al. (1999) CT and ultrasound features of metanephric adenoma in adults with pathologic correlation. J Comput Assist Tomogr 23:441–444

    Article  PubMed  CAS  Google Scholar 

  • Forman HP, Middleton WD, Melson GL et al. (1993) Hyperechoic renal cell carcinomas: increase in detection at US. Radiology 188:431–434

    PubMed  CAS  Google Scholar 

  • Hajdu SI, Thomas AG (1967) Renal cell carcinoma at autopsy. J Urol 97:978–982

    PubMed  CAS  Google Scholar 

  • Herts BR, Coll DM, Novick AC et al. (2002) Enhancement characteristics of papillary renal neoplasms revealed on triphasic helical CT of the kidneys. Am J Roentgenol 178:367–372

    Google Scholar 

  • Hsu RM, Chan DY, Siegelman SS (2004) Small renal cell carcinomas: correlation of size with tumor stage, nuclear grade, and histologic subtype. Am J Roentgenol 182:551–557

    Google Scholar 

  • Jamis-Dow CA, Choyke PL, Jennings SB et al. (1996) Small (≤3 cm) renal masses: detection with CT versus US and pathologic correlation. Radiology 198:785–788

    PubMed  CAS  Google Scholar 

  • Jinzaki M, Tanimoto A, Mukai M et al. (2000) Double-phase helical CT of small renal parenchymal neoplasms: correlation with pathologic findings and tumor angiogenesis. J Comput Assist Tomogr 24:835–842

    PubMed  CAS  Google Scholar 

  • Jinzaki M, McTavish JD, Zou KH et al. (2004) Evaluation of small (≤3 cm) renal masses with MDCT: benefits of thin overlapping reconstructions. Am J Roentgenol 183:223–228

    Google Scholar 

  • Kim JJ, Kim TK, Han JA et al. (2004) Differentiation of subtypes of renal cell carcinoma on helical CT scans. Am J Roentgenol 178:1499–1506

    Google Scholar 

  • Levine E, Huntrakoon M, Wetzel CH (1989) Small renal neoplasms: clinical pathologic and imaging features. Am J Roentgenol 153:69–73

    CAS  Google Scholar 

  • Macari M, Bosniak MA (1999) Delayed CT to evaluate renal masses incidentally discovered at contrast-enhanced CT: demonstration of vascularity with deenhancement. Radiology 213:674–680

    PubMed  CAS  Google Scholar 

  • Petersen RO (1992) Kidney: neoplastic disorders. In: Petersen RO (ed) Urologic pathology. Lippincott, Philadelphia, p 77

    Google Scholar 

  • Pretorius ES, Siegelman ES, Ramchandani P et al. (1999) Renal neoplasms amenable to partial nephrectomy: MR imaging. Radiology 212:28–34

    PubMed  CAS  Google Scholar 

  • Reis M, Faria V, Lindoro J et al. (1988) The small cystic and noncystic noninflammatory renal nodules: a postmortem study. J Urol 140:721–723

    PubMed  CAS  Google Scholar 

  • Rendon RA, Stanietzky N, Panzarella T et al. (2000) The natural history of small renal masses. J Urol 164:1143–1147

    PubMed  CAS  Google Scholar 

  • Rybicki FJ, Shu KM, Cibas ES et al. (2003) Percutaneous biopsy of renal masses: sensitivity and negative predictive value stratified by clinical setting and size of masses. Am J Roentgenol 180:1281–1287

    Google Scholar 

  • Scialpi M, DiMaggio A, Midiri M et al. (2000) Small renal masses: assessment of lesion characterization and vascularity on dynamic contrast-enhanced MR imaging with fat suppression. Am J Roentgenol 175:751–757

    CAS  Google Scholar 

  • Semelka RC, Hricak H, Stevens SK et al. (1991) Combined gadolinium-enhanced and fat saturation MR imaging of renal masses. Radiology 178:803–809

    PubMed  CAS  Google Scholar 

  • Siegel CL, Middleton WD, Teefey SA et al. (1996) Angiomyolipoma and renal cell carcinoma: US differentiation. Radiology 198:785–788

    Google Scholar 

  • Siegel CL, Fisher AJ, Bennett HF (1999) Interobserver variability in determining enhancement of renal masses on helical CT. Am J Roentgenol 172:1207–1212

    CAS  Google Scholar 

  • Silverman SG, Lee BY, Seltzer SE et al. (1994) Small (≤to 3 cm) renal masses: correlation of spiral CT features and pathologic findings. Am J Roentgenol 163:597–605

    CAS  Google Scholar 

  • Smith SJ, Bosniak MA, Megibow AJ et al. (1989) Renal cell carcinoma: earlier discovery and increased detection. Radiology 170:699–703

    PubMed  CAS  Google Scholar 

  • Someren A, Zaatari GS, Campbell WG et al. (1989) Tumors of differentiated tubular epithelium: renal “adenoma” and adenocarcinoma. In: Someren A (ed) Urologic pathology with clinical and radiologic correlations. Macmillan, New York, pp 162–163

    Google Scholar 

  • Steinberg AP, Lin CH, Matin S et al. (2003) Impact of tumor size on laparoscopic partial nephrectomy: analysis of 163 patients (Abstract). J Urol 169 (Suppl):174a

    Google Scholar 

  • Szolar DH, Kammerhuber F, Altzieber S et al. (1997) Multiphasic helical CT of the kidney: increased conspicuity for detection and characterization of small (>3 cm) renal masses. Radiology 201:211–217

    Google Scholar 

  • Takebayashi S, Hidai H, Chiba T et al. (1999) Using helical CT to evaluate renal cell carcinoma in patients undergoing hemodialysis: value of early enhanced images. Am J Roentgenol 172:429–433

    CAS  Google Scholar 

  • Takebayashi S, Hidai H, Chiba T et al. (2000) Renal cell carcinoma in acquired cystic kidney disease: volume growth rate determined by helical computed tomography. Am J Kidney Dis 36:759–766

    PubMed  CAS  Google Scholar 

  • Talamo TS, Shonnard JW (1980) Small renal adenocarcinoma with metastases. J Urol 124:132–134

    PubMed  CAS  Google Scholar 

  • Tuncali K, van Sonnenberg E, Shankar S et al. (2004) Evaluation of patients referred for percutaneous ablation of renal tumors: importance of a preprocedural diagnosis. Am J Roentgenol 183:575–582

    Google Scholar 

  • Urban BA, Buckley J, Soyer P et al. (1997) CT appearance of transitional cell carcinoma of the renal pelvis. Am J Roentgenol 169:157–168

    CAS  Google Scholar 

  • Volpe A, Panzarella T, Rendon RA et al. (2004) The natural history of incidentally detected small renal masses. Cancer 100:738–745

    Article  PubMed  Google Scholar 

  • Warshauer DM, McCarthy SM, Street L et al. (1988) Detection of renal masses: sensitivities and specificities of excretory urography/linear tomography, US and CT. Radiology 169:363–365

    PubMed  CAS  Google Scholar 

  • Yamashita Y, Takahashi M, Watanabe O et al. (1992) Small renal cell carcinoma: pathologic and radiologic correlation. Radiology 184:493–498

    PubMed  CAS  Google Scholar 

  • Yuh BI, Cohan RH (1999) Detecting and characterizing renal masses during helical CT. Am J Roentgenol 173:747–755

    CAS  Google Scholar 

  • Zagoria RJ (2000) Imaging of small renal masses: a medical success story. Am J Roentgenol 175:945–955

    CAS  Google Scholar 

  • Zagoria RJ, Wolfman NT, Karstaedt N et al. (1990) CT features of renal cell carcinoma with emphasis on relation to tumor size. Invest Radiol 25:261–266

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2006 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Curry, N.S. (2006). Small Renal Neoplasms. In: Guermazi, A. (eds) Imaging of Kidney Cancer. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-30003-1_13

Download citation

  • DOI: https://doi.org/10.1007/3-540-30003-1_13

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-21129-7

  • Online ISBN: 978-3-540-30003-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics