Firstly, the most common benign tumour of kidney is a RENAL ONCOCYTOMA, Its clinically and radiologically indistinguishable from a renal cell carcinoma (RCC). A diagnosis of an oncocytoma is only confirmed after the final surgical removal and histopathological examination under a microscope. Even A frozen section is not recommended to distinguish RCC FROM ONCOCYTOMA
Secondly, another important benign mass which needs to be treated is a ANGIOLIPOMA, its easily diagnosed radiologically due to presence of fat( finding 20 pixels with attenuation less than -20 HU , or 5 pixels with attenuation less than -30 HU ,on a CT scan is a diagnostic hallmark). MOREOVER AML always indents into the renal parenchyma, whereas liposarcomas will only extrinsically push the renal parenchyma. 30 to 50% of these tumor can present with a haemorrhage or life threatening bleeding, especially if more than 4 cm.
Treatment of AML : in setting of acute haemorrhage, selective angioembolisation is first line therapy.
In other situations, for AML going to 4 cm or more, as best treated with a partial nephrectomy , as embolisation has drawbacks in form of a high rate of secondary procedures, extended follw up , and risk of contrast induced renal damage during angio-embolisation
Thirdly , another important but uncommon benign tumor is a JG CELL tumor or Reninoma, which presents with uncontrolled hypertension and hypokalemia. Surgical removal with a partial nephrectomt treats this issue.
However when cost is not the issue , i shall do a robotic procedure, as its less stressful for me..
However when cost is not the issue , Dr. Soumyan Dey shall do a robotic procedure, as its less stressful for him..