To show pitfalls in management of SMRs with reference to proper treatment according to European Association of Urology recommendations.
Small renal masses (SRMs) are common incidental findings in abdominal imaging.
It is reported,
that 20-30% of them are benign lesions.
SRMs are confined to kidney,
below 4cm in the largest diameter (T1a); they show good overall prognosis.
Despite the European Association of Urology guideline on SMRs,
performed management is often doubtful and leads to overtreatment.
Findings and procedure details
We have analyzed the imaging,
and postoperative histopathological results of 38 patients with SRMs who underwent radical nephrectomy,
nephron sparing surgery,
or radiofrequency ablation.
In this poster we included the most interesting cases from the analyzed group of patients.
Case 1. 77-yo patient with incidentally finding of SRM sized 16x16x16mm in the central part of right kidney treated with radical nephrectomy (Fig.1).
According to the European Association of Urology guideline  elderly and comorbid patients with SRMs have low RCC-specific mortality and significant...
Imaging characterstics of the different SRMs cannot predict their pathomorphological nature
To reduce the overtreatment of SRMs and the rate of intervention for benign lesions,
the renal tumor biopsy should be performed as well as a proper radiological management
Active Surveillance should be considered in the management of SRMs in elderly patients with multiple comorbidities
Radiofrequency Ablation is a safe method of treatment of peripheral lesions,
especially in patients with comorbidities and solitary kidney
Irreversible Electroporation is a new,
promising option in unfavorably localized tumors
Oliwia Kozak email: email@example.com,
Department of Radiology,
Medical University of Gdansk,
EAU guidelines on renal cell carcinoma,
European Association of Urology 2017.
Update March 2017.
Available at: http://uroweb.org/wp-content/uploads/10-Renal-Cell-Carcinoma_2017_web.pdf
Initial assessment of the efficacy of irreversible electroporation in the focal treatment of localized renal cell carcinoma with delayed-interval kidney tumor resection (Irreversible Electroporation of Kidney Tumors Before Partial Nephrectomy [IRENE] Trial-An Ablate-and-Resect Pilot Study).
Urology 2018 Apr;114:224-232.
Management of a renal mass in a solitary...