[Management of asymptomatic small tumor of the kidney of incidental discovery].
OBJECTIVE
The incidental discovery of renal tumours is increasingly frequent. All small renal tumours are not inevitably cancers. The objective of our study was to compare radiological and histological data and to establish a diagnostic and therapeutic approach to the incidental discovery of a small renal tumour.


METHODS
Retrospective study of 22 incidentally discovered asymptomatic renal tumours, with a long axis of less than 5 cm on the pathology specimen.


RESULTS
The tumour was discovered on ultrasound in 68% of cases. All patients were operated, allowing histological examination of the operative specimen, revealing 14 cancers, 4 angiomyolipomas, 2 adenomas and 2 haemorrhagic cysts (with thick contents). Ultrasound demonstrated a hypoechoic tumour in 13 cases, 11 of which were cancers, and a hyperechoic tumour in the other 7 cases, corresponding to 4 angiomyolipomas, 2 cancers, and 1 adenoma. Computed tomography showed a heterogeneous tumour in 12 cases, corresponding to a cancer in all but one case. The tumour was homogeneous in the other 10 cases, including 4 cancers. Arteriography showed a hypervascular tumour in 3 cases, all cancers, and a hypovascular tumour in 7 cases: 2 cancers, 2 adenomas, 2 very small angiomyolipomas and 1 haemorrhagic cyst.


CONCLUSIONS
Despite the development of medical imaging, further progress is required to resolve the diagnostic problems raised by certain incidentally discovered asymptomatic renal tumours, particularly tumours with a homogeneous appearance on CT scan and a hypovascular appearance on arteriography.
Smaoui
S
S
Service d'Urologie, Centre Hospitalier Général de la Miséricorde, Ajaccio, France.
Fanton
Y
Y
Peraldi
R
R
Pernin
F
F
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D014463:Ultrasonography
Conduite à tenir devant une petite tumeur du rein asymptomatique de découverte fortuite.