Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for evaluation of a Bosniak IV renal cyst identified on imaging. Mass exhibits thickened, irregular, enhancing walls with solid nodular components. Denies gross hematuria, flank pain, or constitutional symptoms. No history of VHL or hereditary renal cancer syndromes.
Clinical Examination Findings
Patient is alert and oriented. Vitals stable. Abdominal exam: No palpable masses or costovertebral angle (CVA) tenderness. No peripheral edema. Skin clear of stigmata of renal malignancy.
Treatment Protocol
Referral to Urologic Oncology for surgical consultation. Recommended management: Partial or radical nephrectomy given high malignancy risk (90-100%). Pre-operative staging CT/MRI of chest/abdomen/pelvis ordered.