Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for evaluation of a renal mass incidentally discovered on imaging. Denies gross hematuria, flank pain, or constitutional symptoms. No history of Tuberous Sclerosis Complex (TSC) or family history of renal neoplasms. Current imaging characteristics consistent with fat-containing renal lesion.
Clinical Examination Findings
Abdominal examination: Soft, non-tender, no palpable renal masses or organomegaly. Flank tenderness absent. Vital signs stable. Cardiovascular and respiratory exams unremarkable. Skin assessment: No evidence of adenoma sebaceum, shagreen patches, or ash-leaf spots suggestive of TSC.
Treatment Protocol
Management plan: Active surveillance with serial renal imaging (US/CT/MRI) every 6-12 months for lesions <4cm. For lesions >4cm or symptomatic cases, consider selective arterial embolization or nephron-sparing surgery (partial nephrectomy). mTOR inhibitors (e.g., Everolimus) indicated if associated with TSC or unresectable disease.