This AUA Guidelines focuses on the evaluation and management of clinically localized sporadic renal masses suspicious for renal cell carcinoma (RCC) in adults, including solid enhancing renal tumors and Bosniak 3 and 4 complex cystic renal masses. Practice patterns regarding treatment vary considerably, and the literature regarding evaluation, management, and surveillance has been rapidly evolving.

Renal masses are a biologically heterogeneous group of tumors ranging from benign masses to cancers that can be indolent or aggressive. The true incidence of renal masses (including benign masses) is unknown. However, benign masses comprise approximately 15-20% of surgically resected tumors < 4 cm and allow estimations of benign incidence based on kidney cancer statistics. The vast majority (greater than 90%) of kidney cancers in the United States are renal cortical tumors known as RCC. Recommendations included in this Guideline discuss the following:

• Evaluation
• Counseling
• Renal mass biopsy
• Management
  • Partial nephrectomy and nephron-sparing approaches
  • Radical nephrectomy
  • Surgical principles
  • Thermal ablation
  • Active surveillance
• Follow-up after intervention

Guideline Statements