‘BJUI Clinical Dilemma’: the incidental small renal mass in a solitary kidney

Introduction

The incidental small renal mass (SRM; ≤4 cm; clinical T stage [cT]1a) has become increasingly common due to the widespread utilisation of ultrasonography and cross-sectional imaging. Today, most such patients present with asymptomatic, localised disease that can be surgically treated with curative intent; however, up to 25% of SRMs are benign [1]. This creates a clinical dilemma: balancing the removal of malignant tumours with avoiding needless active treatment for benign masses.

This ‘BJUI Clinical Dilemma’ presents a structured format to address the common clinical presentation of a SRM through a case vignette approach. Following the vignette, leading experts will provide brief commentary, explaining the rationale behind their preferred management strategies. This approach encourages a balanced, expert-driven discussion on alternative strategies, offering readers insights into decision-making processes for common, yet nuanced cases in urological practice.