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Cancer of the kidney frequently presents without overt signs or symptoms. Almost one third of such patients, in our experience, do not have signs or symptoms suggesting renal disease. Many patients with unsuspected renal neoplasms are discovered to have a renal mass during some nonurologic roentgenographic examination. Differentiation between renal cyst and neoplasm is usually not possible by conventional urographic means, except in those cases where there is characteristic deformity of the renal collecting system. In order to test the diagnostic vulnerability of conventional pyelography in the differentiation of renal cyst from neoplasm, we presented a series of 50 cases of undiagnosed renal masses to five experienced radiologists and found that a careful study allows correct diagnosis of either cyst or neoplasm in only 50% of cases. It is of further interest that in only 10% of the series was there agreement among the five observers in the diagnosis of
Evans J. The Accuracy of Diagnostic Radiology: Arteriography and Nephrotomography. JAMA. 1968;204(3):223–226. doi:10.1001/jama.1968.03140160033009
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