Debra A. Gervais, MD

Over 35,000 new cases of renal cell carcinoma occurred in the U.S. in 2001,1 most of them detected as incidental imaging findings on CT, MR, or ultrasound.2,3 Since most of these tumors are relatively small when detected, the classic clinical triad of flank pain, hematuria, and palpable mass is now rarely encountered. Many of these incidentally discovered RCCs are also slow growing. Bosniak et al showed that RCCs smaller than or equal to 3.5 cm grow at an average rate of 0 to 1.1 cm/year (mean 0.36 cm/year).4