How frequently are solid renal masses treated with radical nephrectomy benign?

Updated: Feb 05, 2019
  • Author: Richard A Santucci, MD, FACS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

Radical nephrectomy has been the traditional approach to treating solid renal masses. However, not all solid renal masses are malignant. As the number of incidentally detected solid renal masses increases because of widespread radiographic imaging, the incidence of benign tumors appears to be increasing.

In a prospective study of 106 solid renal masses treated with surgical resection, Dechet et al showed that 15 (14%) were benign. [8] Oncocytomas compromised most masses, with an overall 10% incidence rate of solid renal masses. Given the high incidence of benign tumors, especially among solid renal masses 4 cm in diameter or smaller, radical nephrectomy seems excessive in all cases. However, identifying these cases preoperatively using radiographic imaging and/or fine-needle biopsy or aspiration is impossible.


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