Management of Small Renal Masses in the Older Adult

Small renal masses in older adults are common and usually found incidentally. Although many small renal masses are benign, most are malignant. In older patients, the small renal mass poses a challenge because the treatment paradigm has to strike the balance between competing comorbidities and a lethal cancer. Partial nephrectomy, mainly via robot-assisted technique, has gained favor over radical nephrectomy as the intervention of choice. Cryoablation and radiofrequency ablation are also viable treatment options and have a role to play in patients who desire treatment but either are not suitable surgical candidates or prefer not to have a surgical intervention.