Management of the incidentally detected solid renal mass.

Solid renal masses are being increasingly detected incidentally in individuals with no urologic symptoms. Contemporary imaging modalities allow the diagnosis of RCC to be established with 85% to 90% accuracy. Some solid renal masses with radiographic characteristics of RCC will ultimately prove to be a benign adenoma or oncocytoma. Recent data suggest that radical nephrectomy and nephron-sparing surgery each provide effective curative treatment for patients with a single, small, unilateral, localized RCC. The long-term renal functional advantage of nephron-sparing surgery with a normal opposite kidney remains unproven. Radical nephrectomy remains the treatment of choice for patients with larger (> 4 cm) or multiple localized renal cell carcinomas.