Decision aid · Kidney

Treatment Options for Kidney Mass

The options when a scan finds a kidney mass.

Most kidney masses are found by chance on a scan done for another reason. Not all are cancer, and smaller masses are more likely to be benign. Even when a small mass is cancer, it often grows slowly — which is why monitoring is a legitimate choice rather than a failure to act.

01

Tumour size and treatment options

Size of a solid massChance it is benignWhat this usually means
Under 4 cmAbout 20%Monitoring, partial nephrectomy where feasible, or ablation
Over 4 cm up to 7 cmAbout 10%Usually treated; partial nephrectomy where technically feasible, otherwise the whole kidney is removed
7 cm or largerAbout 6%Usually treated; the whole kidney is removed
02

What happens with each treatment option?

What to compareMonitoringPartial nephrectomyRemoving the kidneyAblation
What happensScans at intervalsMass removed, most of normal kidney preservedWhole kidney removedMass destroyed by heat or cold
AnaestheticNoneGeneralGeneralUsually sedation or general
Hospital stayNone1–2 nights1–2 nightsOften day case
Kidney functionUnchangedMostly preservedReduced overallMostly preserved
Diagnosis confirmed?No, unless biopsiedYes, full pathologyYes, full pathologyOnly if biopsied first
Main trade-offUncertainty; small risk of growthAn operation; small risk of bleeding, urine leak, or requiring whole-kidney removalLoses a whole kidneyCancer can remain or recur; close monitoring needed

Have a question about this condition?

Dr Tan consults at SJMC, Kuala Lumpur.

Disclaimer: This information is for general education and is not a substitute for personal medical advice.