With the advent of sonography and computed tomography, detection of fo
cal renal masses has increased; in most cases, correct characterizatio
n of these masses can be made on this initial examination. Occasionall
y, however, the precise nature of the mass is uncertain on the initial
study and additional evaluation is required to assess the true nature
of the lesion. Such lesions are referred to as indeterminate renal ma
sses and include complex cystic masses, small renal tumors, fat-contai
ning masses, and other ''problematic'' lesions. This article describes
an approach to such patients, and a protocol for their evaluation is
proposed.