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Kidney Cancer

Renal Mass/Cyst Clinic

Abnormalities on the kidney are very common.  These can be detected by CT scans, MRI scans, or ultrasounds obtained for seemingly unrelated reasons.  Most of these abnormalities are cysts.  These are fluid collections inside or around the kidney.  About half of people 50 years old will have cysts somewhere on their kidneys.  Very, very few of these cysts cause any problems that a person can feel like pain.  Sometimes, the cyst will look abnormal.  This could mean that this cyst is cancerous.  Cystic kidney cancers do happen, but they don't usually spread around the body or hurt people.  We will recommend that these cysts either be watched closely with more tests (like CT scans) or be removed by surgery.  If the cyst grows or changes on a new scan, we might recommend that the cyst be removed by surgery (see partial nephrectomy).

Solid tumors on the kidney are sometimes detected by these scans, too.  Solid tumors are usually kidney cancers, but not every kidney cancer will spread around the body or hurt people.  If they are small, we can sometimes decide that checking the tumor with a scan is ok.  These scans might be done a few times a year.  Most of the time, the tumors don't grow quickly or at all.  If people are young or very healthy, we feel that removing these small tumors with surgery is better (see partial nephrectomy). Bigger tumors are more worrisome and we will talk with patients about removing them with surgery (see radical or partial nephrectomy).  

Sometimes these tumors are not cancer.  If we think the tumor might not be cancer, we can do a biopsy.  The biopsy usually involves passing a needle through the skin into the tumor to take a small piece of it.  This is a very tolerable procedure that takes about an hour and most people leave the hospital the same day. 

If a tumor is cancer and looks just right, we might be able to do a freezing procedure to try to kill the cancerous tissue.  Like the biopsy, a doctor passes a small needle through your side or back into the tumor.  This special needle gets very cold and causes the tissues near the tip to die.  This procedure takes a few hours and recovery is usually very quick.

Large tumors on the kidney and kidney cancer that have spread around the body frequently need surgery as part of the treatment.  Surgery to remove the kidney can be very complicated.  If tumors are big (like a cantaloupe), we might need to make a big incision to remove the cancerous kidney (see open radical nephrectomy).  If the tumors are smaller (like a grapefruit), we can usually remove the kidney with small incisions and telescopes (see laparoscopic radical nephrectomy).  If tumors are the size of a walnut, we can usually remove the tumor only and leave the rest of the kidney.  

As you can see, there is a lot that goes into trying to make a decision about the right thing to do for an abnormality on the kidney.  We would be happy to talk with you about it.  If you have a complex or complicated kidney cyst or a small mass on the kidney, please schedule a visit with our healthcare professionals at ...