International Journal of Clinical Oncology

, Volume 20, Issue 1, pp 150–155 | Cite as

Preoperative differentiation between benign and malignant renal masses smaller than 4 cm treated with partial nephrectomy

  • Masatomo Nishikawa
  • Hideaki Miyake
  • Kazuhiro Kitajima
  • Satoru Takahashi
  • Kazuro Sugimura
  • Masato Fujisawa
Original Article



The aim of this study is to accurately differentiate between benign and malignant small renal masses (SRMs) prior to surgery.


The study included 144 patients with SRMs <4 cm suspected to be renal cell carcinoma (RCC) based on several imaging examinations, who subsequently underwent partial nephrectomy. Clinicopathological data were analyzed based on the preoperative findings obtained from enhanced computed tomography (CT) as follows: group 1 showing a typical imaging pattern for clear cell RCC (CCRCC), and group 2 showing an imaging pattern atypical of CCRCC. We then evaluated the association between clinicopathological characteristics and pathological diagnosis in order to identify factors which can predict the pathological diagnosis.


Based on the criteria, 102 (70.8 %) and 42 (29.2 %) patients were classified into group 1 and group 2, respectively. The only independent factor identified to predict the final pathological diagnosis of the 144 patients was preoperative CT findings. Only 7 (6.9 %) patients were pathologically diagnosed with benign tumors in group 1; however, 13 (31.0 %) of the 42 patients in group 2 appeared to have pathologically confirmed benign tumors. A younger age and lower body mass index (BMI) in group 2 were shown to be independently associated with benign histology on multivariate analysis.


The proportion of patients with benign tumors was comparatively high in those with CT findings atypical for CCRCC; therefore, other clinical parameters, such as age and BMI, should be considered when determining therapeutic strategies for patients with such SRMs.


Small renal mass Enhanced computed tomography Age Body mass index 


Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Japan Society of Clinical Oncology 2014

Authors and Affiliations

  • Masatomo Nishikawa
    • 1
  • Hideaki Miyake
    • 1
  • Kazuhiro Kitajima
    • 2
  • Satoru Takahashi
    • 2
  • Kazuro Sugimura
    • 2
  • Masato Fujisawa
    • 1
  1. 1.Division of UrologyKobe University Graduate School of MedicineKobeJapan
  2. 2.Division of RadiologyKobe University Graduate School of MedicineKobeJapan

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