Does a 6cm renal hamartoma require surgery? How big a renal hamartoma requires surgery?

Renal hamartoma is composed of abnormally proliferating and degenerating blood vessels, smooth muscles and fat in different proportions. Generally speaking, surgery can be performed when the diameter of a renal hamartoma is greater than 4cm, so surgery is required when the renal hamartoma is 6cm. If the tumor diameter is less than 4cm, but the tumor's growth location and development are not optimistic, and the hidden dangers are great, this also needs surgery as soon as possible.

Renal hamartoma is a benign tumor, so if it is treated promptly and properly, the prognosis is good and it will not have a big impact on daily life. The size of the tumor is an important basis for doctors to determine whether surgery is needed. After surgical resection, it can be cured and is not prone to recurrence. So does a 6cm renal hamartoma require surgery? How big a renal hamartoma requires surgery?

1. When a renal hamartoma grows to 6 cm, surgery is required. The appropriate surgical plan is selected based on the development of the tumor, such as whether it compresses surrounding organs, whether there is a risk of rupture and bleeding, and the physical condition. Resection as soon as possible is also conducive to postoperative recovery.

Treatment principles

Tumors <4 cm are not treated; giant renal hamartomas may be treated with nephrectomy.

Treatment strategy

Tumors <4 cm may not require treatment, but close follow-up is required. Tumors <5 cm may require enucleation; giant renal hamartomas may require nephrectomy.

Surgery

1. Nephron-sparing surgery

Tumors <5 cm can be enucleated, especially those at the edge of the kidney. For cases with smaller tumors, laparoscopic nephron-sparing partial nephrectomy (LpN) is an effective surgical treatment.

2. Nephrectomy

Giant renal hamartomas can be treated with partial or complete nephrectomy. If the disease is bilateral, more consideration should be given to the preservation of renal function. In a few cases, there may be local and lymph node invasion, or even tumor thrombus invasion of large veins, showing malignant behavior, and radical nephrectomy should be performed.

Other treatments

1. Embolism

Arterial embolization should first be considered in cases of bleeding. According to experience, the volume of the tumor does not decrease after embolization, but the bleeding can be stopped. Superselective renal artery branch embolization is often used to protect some renal function.

2. Kidney transplantation or hemodialysis

It is only suitable for patients who must undergo bilateral nephrectomy due to bilateral lesions leading to renal failure or tumor rupture and bleeding.

Prognosis

Unilateral renal hamartoma is a benign lesion with a good prognosis. Bilateral, multiple lesions and renal insufficiency still affect the quality of life despite conservative treatment. In a few cases where multiple organs are invaded, such as lymph nodes, brain, heart, or even blood vessels, the prognosis depends on the degree and range of the invaded organs.