The authors present six cases of cystic renal cancers which raised preopera
tive and intraoperative diagnostic difficulties. Computed tomography is cur
rently the most reliable diagnostic examination. The diagnosis of complicat
ed benign cyst must be made cautiously and persistence of doubtful images m
ust lead to surgical exploration. The authors try to up-date the diagnostic
strategy for atypical cysts based on recent progress in medical imaging an
d propose a practical approach to treatment.