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Partial Nephrectomy for Cancer May Reveal Benign Lesion

Lesion is benign in 16 percent of cases; parenchyma-sparing techniques may be best

TUESDAY, Oct. 31 (HealthDay News) -- Despite expert radiologic interpretation, about 16 percent of small, solitary renal masses thought to be renal cancer and treated with partial nephrectomy turn out to be benign. Parenchyma-sparing methods should be performed in patients with suspected renal cell carcinoma to prevent undue morbidity, according to a study in the October issue of Urology.

Alexander Kutikov, M.D., of the Hospital of the University of Pennsylvania in Philadelphia, and colleagues evaluated data from 143 patients who had resection of a single kidney lesion thought to be renal cell carcinoma. Genitourinary radiologists interpreted the preoperative scans.

Of the 143 resected masses, 23 were benign (16.1 percent). Of those, 10 lesions (43.5 percent) were angiomyolipomas, eight (34.8 percent) were oncocytomas and three lesions (13 percent) were benign Bosniak-type cysts. There was one low-grade spindle cell lesion consistent with mesoblastic nephroma, and one metanephric adenoma.

Patients with small, solitary renal masses presumed to be renal cell carcinoma should be managed with "parenchyma-sparing approaches, because resection serves not only a therapeutic but also a diagnostic function," the authors conclude. "Patients should be counseled accordingly when faced with the diagnosis of renal mass."

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