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Solid renal masses are often found incidentally in patients undergoing abdominal imaging for other reasons; most such masses are renal cell carcinomas (RCCs) histologically. Because small RCCs in older patients often do not progress during several years of follow-up, it may be reasonable to observe such patients without treatment, especially if they are poor surgical candidates. Several recent reports shed additional light on the characteristics and treatment of small renal masses.
Remzi and colleagues describe 287 small renal masses that were removed surgically; 59% were ≤3 cm in diameter, and 41% were 3.1 to 4.0 cm. About 80% of tumors in both size groups were RCCs. The prevalence of high-grade histology (suggesting poorer prognosis) was 5…