ADPKD RCC Risk Not Increased — ESENeph MCQ
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Correct answer: B — Arrange specialist assessment of the enhancing renal mass
The best answer is “Arrange specialist assessment of the enhancing renal mass”. Enhancement is the critical malignant imaging signal. The lesion is assessed on its own merits with renal multidisciplinary input, taking kidney function and nephron preservation into account. “Assume it is a benign ADPKD cyst and perform no further assessment” is less appropriate because a new enhancing solid component is not explained by a simple cyst “Treat empirically as renal infection without clinical or imaging evidence of infection” is less appropriate because enhancement within a discrete mass requires oncological characterisation “Drain the lesion as a simple cyst before specialist review” is less appropriate because puncture of a potentially malignant mass is inappropriate without a planned diagnostic pathway “Use family history of intracranial aneurysm to classify the renal lesion” is less appropriate because aneurysm risk does not determine renal-mass pathology
Reference: EAU renal cell carcinoma guideline: https://uroweb.org/guidelines/renal-cell-carcinoma/chapter/diagnostic-evaluation