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The American Cancer Society estimated that >58 000 patients will be diagnosed with a renal malignancy in 2011, resulting in 13 000 deaths, with renal cell carcinoma constituting most of those tumors.The diagnosis of small renal masses (SRMs), usually defined as a renal mass <4 cm, has increased in recent years, especially in patients in their eighth decade, mostly due to the increased use of ultrasound and computed tomography (CT).