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Simplified Imaging Approach for Evaluation of the Solid Renal Mass in Adults¹

¹ From the Department of Radiology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157 (R.D., D.J.D.); and Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Conn (B.L.M.). Received October 27, 2006; revision requested January 8, 2007; revision received January 30; accepted April 16; final version accepted May 14. Address correspondence to R.D. (e-mail: rdyer{at}wfubmc.edu).

Current patterns of imaging utilization lead to frequent serendipitous discovery of renal lesions. Today, the majority of solid renal masses that are ultimately proved to be renal cell carcinomas were incidental findings on imaging studies performed for non–urinary tract symptoms. While earlier discovery has led to treatment of smaller and earlier-stage malignancies, the percentage of benign lesions discovered has also increased. A strategy for characterization of solid masses in adults based on the lesion's growth pattern, the "ball" versus the "bean," is presented. Common and uncommon renal masses, in concert with clinical and other imaging clues, are reviewed within the context of a renal ball or bean.

© RSNA, 2008