Kidney Masses Small Renal Mass Surveillance

Kidney masses are becoming more common due in part to increased imaging. Many of these masses are incidentally found when investigating another medical condition with imaging. Investigation and treatment of these masses will depend on the characteristics of the mass and on the patient’s age and other medical conditions. While surgery is usually required for most renal masses, observation is an option for small renal masses.


Mr Thyer will see you in his rooms, look at the imaging that has identified the mass and ask about your other medical conditions. The next step is to perform a dedicated CT scan specifically to look at the kidney mass. Provided the imaging is not concerning the Mr Thyer may recommend surveillance rather than treatment. Occasionally a biopsy is required to make the right decision on treatment versus surveillance.

Advantages of surveillance
  • No operation is required
  • Kidney function is preserved
  • Most small renal masses are low grade and do not cause issues in future
Disadvantages of surveillance
  • The mass may grow and could even spread between surveillance scans
  • Anxiety of not treating the mass

A large study looking at surveillance for renal masses was published in 2012 in the journal Cancer. Data from multiple studies was drawn together and analysed. A total of 880 patients with small renal masses were included. Some of the key findings are presented in Q and A format below:

Q: How frequently do these masses grow?
A: Of the masses in this study 23% did not grow at all over approximately 3 years

Q: How fast do they grow?
A: Of those that grew, growth was approximately 4.5 mm per year on average

Q: How frequently do they spread?
A: 2% of patients under surveillance developed metastases (spread of cancer)

Q: How frequently do patients switch from surveillance to treatment?
A: 45% switched to treatment, 55% continued with surveillance over the 3 year period

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