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Renal Cell Carcinoma — RACP Adult Medicine MCQ

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EasyNephrologyRenal Cell CarcinomaRACP Adult Medicine

A 58-year-old man presents with painless visible haematuria. Urine microscopy shows isomorphic (non-glomerular) red blood cells without casts. No proteinuria. CT KUB shows a 4 cm enhancing renal mass. What is the most likely urinalysis interpretation?

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Correct answer: E — Non-glomerular (urological) haematuria

Painless visible haematuria with isomorphic (uniform, non-dysmorphic) red blood cells without casts or proteinuria indicates a non-glomerular (urological) source. An enhancing renal mass is suspicious for renal cell carcinoma. Urgent urology referral for further characterisation (biopsy or partial/radical nephrectomy) is required.

Reference: KHA – 2024 – Haematuria Guidelines; Cancer Council Australia