Does renal hamartoma require surgery? Surgery is recommended to eliminate renal hamartoma in three situations

Renal hamartoma is a benign tumor, so when the tumor is small and does not affect daily life, conservative treatment can be performed, and regular check-ups at the hospital are required. Pay more attention to daily life, eat a reasonable diet, maintain a regular work and rest schedule, and strengthen exercise. However, when the renal hamartoma is large, compresses and invades surrounding organs, or ruptures and bleeds, surgery is recommended as soon as possible.

Since renal hamartoma is a benign lesion, most cases have a good prognosis after surgical resection. However, some cases do not require surgery because the tumor is small and does not affect normal life. Clinically, it is necessary to choose an appropriate treatment plan based on the condition, the size of the tumor, whether the tumor is found to be invasive or bleeding, etc. So does renal hamartoma require surgery? In which three situations is surgery recommended to eliminate renal hamartoma?

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.