Abstract
Objective. To investigate the size of renal cell carcinomas (RCCs) when they cause macroscopic hematuria or other symptoms and/or signs. Material and methods. A retrospective review of 232 patients (136 males, 96 females; mean age 68±11 years; age range 40–90 years) with a diagnosis of RCC was undertaken. Patients were grouped according to the presenting symptoms and/or signs caused by the RCCs. Tumor size was measured on CT images. Results. Of the RCCs, 29% were found incidentally and 71% caused symptoms and/or signs. The incidentally found RCCs measured 4.9±2.6 cm (range 2–12 cm) and RCCs causing symptoms and signs measured 8.9±3.2 cm (range 3–18 cm); this size difference was significant (p<0.001). None of the RCCs causing macroscopic hematuria were <4 cm in size and only 3/165 (2%) of the symptomatic RCCs were <4 cm in size. Discussion. If small (<4 cm) RCCs do not cause symptoms, patients with them will not be referred for CT or any other imaging modality. Therefore, if a 2-cm RCC is found in a patient presenting with macroscopic hematuria, it is unlikely that this small RCC caused the hematuria and another cause of the hematuria must be ruled out.