Radiology of Renal Masses

Abstract

Excretory urography is considered a primary screening examination in the diagnostic workup of a suspected renal mass. When an excretory urogram reveals a mass, another cross-sectional imaging method, either sonography or CT, is employed to define the nature of the lesion. However, when the excretory urogram is considered normal, further studies are usually abundant. The importance of further diagnostic imaging for clinically suspected renal masses undetected by excretory urography should be underlined (Figs. 1–3). Literature reviews of radiology, urology, and pathology experience emphasize the need for vigorous radiologic evaluation in a clinical setting of suspected renal mass [1, 2, 3]. In about two thirds of 100 patients with renal cell carcinoma, the diagnosis had not been established before death [3]. When and how aggressively to pursue the diagnosis of renal cell carcinoma is difficult to answer. Clinical suspicion of renal cell carcinoma arises from a variety of clinical and laboratory findings. Two-thirds of all renal cell carcinomas diagnosed present with either microscopic or gross hematuria.