A Mass Was Found in My Kidney: Does the Whole Kidney Have to Come Out?

The classic trio of pain in the side, blood in the urine and a lump that can be felt is rare today; when it is present, the disease has usually advanced.

Most kidney tumours are now found by chance on an ultrasound or CT scan done for another complaint. That may sound like bad news, but it usually means the tumour was caught early and small.

A contrast-enhanced CT or MRI shows how the mass takes up blood, which helps tell it apart from a benign structure.

Simple kidney cysts are very common and are not cancer; often they do not even need monitoring. If a cyst has partitions, a thickened wall or a part that takes up contrast, the assessment changes. Masses shown by their fat content to be benign (angiomyolipoma) are also assessed separately.

A biopsy is not done in every patient with a kidney mass; contrast imaging is often enough of a guide.

A biopsy is requested when its result would change the treatment decision — for example, when choosing between surveillance and surgery, or when it is unclear whether the mass comes from the kidney.

Some very small masses grow slowly, and some are benign. Especially in older patients or those at high risk from surgery, an accepted approach is to scan the mass at set intervals and intervene only if it grows. This is called active surveillance.

Active surveillance is not neglect but a deliberate decision. For small masses in patients who are not fit for surgery, ablation — destroying the mass by freezing or heating — is also an option.

In small, suitably placed tumours, only the tumour and a thin rim of tissue around it are removed; this is a partial nephrectomy, and the rest of the kidney keeps working.

In large, centrally placed tumours or those surrounding the blood vessels, the whole kidney may need to be removed; this is a radical nephrectomy. Imaging largely shows this decision in advance.

If the tumour turns out to be placed differently than expected during the operation, a planned partial operation may be converted to a radical one. This is not a failure; it is a decision that makes sure the tumour is removed completely, and it is discussed before surgery.

If the remaining kidney is healthy, living with one kidney is usually possible. But the other kidney may develop problems later, and lost kidney function also affects heart and blood-vessel health.

That is why partial nephrectomy is preferred when it is technically possible and safe in cancer terms. This is decisive especially for people with a single kidney, diabetes or reduced kidney function. Even so, removing the tumour completely always comes first.

Send the contrast CT or MRI images themselves, not only the report, together with recent kidney function tests. Whether a partial operation is possible is largely decided from these images.

Plan to stay in Türkiye for around ten to fourteen days. This is an operation inside the abdomen that needs time to heal, and flying too early raises the risk of blood clots in the legs.

Follow-up scans can be done in your own country. Ask for your pathology report and follow-up plan in writing so that your doctor at home can continue it.

Even when the tumour has been removed completely, the disease can return years later. Follow-up intervals are set by the pathology result and the stage: less often when the risk is low, more often when it is high.

Asking directly before surgery, “Will my whole kidney be removed?”, and making sure the answer is based on the imaging, is a natural part of the decision.

This article is general information and does not replace medical advice.