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A kidney neoplasm is an abnormal growth or tumor that can be either benign or malignant. These neoplasms are typically found during an ultrasound, magnetic resonance imaging (MRI) or computed tomography (CT) scan that was ordered to review the internal organs because of some problem with the kidneys or another organ. Fluid-filled neoplasms are often called cysts, while solid neoplasms may also be called tumors, masses, neoplastic cells or neoplasia. Cyst-like neoplasms that look benign are usually not treated, but may be re-evaluated periodically to track any changes. Kidney neoplasms that are dense have a greater chance to be malignant and usually warrant either a more advanced imaging scan or surgery to obtain a sample of the tissue for pathological review.
Once a kidney neoplasm has been identified using an imaging scan, the course of action depends on the consistency of the mass. Neoplasms that resemble a cyst are usually left untreated and are watched periodically for any anatomical changes. Any concentrated neoplasms with a solid core could be malignant and require further investigation. Some physicians may begin by ordering more advanced scans such as three dimensional (3-D) CT scans, CT urography, 3-D MRI angiography or a pyelogram to better see the composition or vascularization of the mass.
A kidney neoplasm that is solid, appears cancer-like or is 3.5 inches (about 9 cm) or greater is usually cancerous. These masses of neoplastic cells will necessitate a more invasive review to determine whether the cells are malignant. The doctor may order an ureterscopy, urinalysis, a fine needle biopsy of the area or even surgery to obtain a sample of the tumor.
Treatment for a malignant kidney neoplasm depends on the size of the tumor, the symptoms the patient is experiencing, other diseases the patient has and the patient’s health and family history. Small tumors that have not metastasized are often treated with a partial nephrectomy or removal of only part of the kidney. A more advanced kidney neoplasm can be treated with a total removal of the kidney called a radical nephrectomy. This is possible because the body has two kidneys. Some neoplasms can also be treated with ablation or the destruction of the abnormal tissue with a cold probe, called percutaneous cryoablation, or with a hot probe, called percutaneous radiofrequency ablation.
Benign kidney neoplasms rarely have any symptoms. Occasionally, however, benign neoplasms of the kidney will cause kidney stones, frequent urinary tract infections, back pain, blood in the urine, or elevated blood pressure. Malignant kidney neoplasia also do not usually have noticeable symptoms, but occasionally may cause weight loss, blood in the urine, a nagging pain in the back or side, fatigue or a fever.