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Van Poppel. Mini-invasive Surg. 2025;9:13 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2025.50

Editorial Open Access

Current management of small renal masses: is there

an optimal choice?

Hendrik Van Poppel
Department of Urology, Katholieke Universiteit (KU) Leuven, Leuven B3000, Belgium.

Correspondence to: Prof. Hendrik Van Poppel, Department of Urology, Katholieke Universiteit (KU) Leuven, Herestraat 49,
Leuven B3000, Belgium. E-mail: hendrik.vanpoppel@kuleuven.be

How to cite this article: Van Poppel H. Current management of small renal masses: is there an optimal choice? Mini-invasive
Surg. 2025;9:13. https://dx.doi.org/10.20517/2574-1225.2025.50

Received: 15 Apr 2025 Accepted: 23 Apr 2025 Published: 28 Apr 2025

Academic Editor: Giulio Belli Copy Editor: Pei-Yun Wang Production Editor: Pei-Yun Wang

The widespread use of imaging techniques - such as ultrasonography, CT scan, and MRI - has led to a
significant increase in the detection of small renal masses. A proportion of these are renal cell carcinomas,
and kidney cancer currently accounts for approximately 4% of adult cancers.

The management of these small renal masses, often referred to as incidentalomas, remains an area of
ongoing debate and uncertainty. Among the available options, active surveillance has come more and more
into the picture, certainly after diagnostic biopsies of small renal masses were demonstrated to be feasible,
safe, and reliable. In older patients or those with significant comorbidities, active surveillance is a justified
approach - not only for lesions that appear benign on imaging, but also for small, low-grade renal cell
carcinomas.

Meanwhile, active treatment options have also evolved considerably. Over the years, we have witnessed
significant progress in surgical technology. While open partial nephrectomy was once the standard
approach for both small and larger renal tumors, the advent of minimally invasive surgical approaches -
especially laparoscopic and robot-assisted procedures - has offered substantial benefits, including reduced
postoperative morbidity, shorter hospital stays, and minimal postoperative pain and discomfort. Today,
robot-assisted partial nephrectomy has become the preferred technique, with published case series
suggesting that even larger and more complex tumors can be managed without resorting to open surgery.

© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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