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Renal Cyst
Aka: Renal Cyst, Renal Incidentaloma, Kidney Cyst, Kidney Incidentaloma
- See Also
- Incidentaloma
- Epidemiology
- Renal Cysts are present in one third of older adults (Incidence increases with age)
- Classification: Bosniak Classification
- Category I: Benign Simple Cyst
- No monitoring needed
- Category II: Benign cystic lesion with some complex features
- No monitoring needed
- Category IIF: Nonenhancing complex cysts >3 cm
- Malignancy risk: 5-10%
- Follow with serial imaging
- Category III: Enhancing complex cysts
- Malignancy risk: 50%
- Surgical resection
- Category IV: Malignant cystic mass
- Surgical resection
- Evaluation
- Simple Renal Cysts
- Benign in most cases
- Complex cysts
- Complex cysts (especially with enhancement on imaging) have increased malignant potential
- Surgical resection for Category III and Category IV lesions
- Labs: Biopsy indications
- Suspected abscess
- Suspected Lymphoma
- Suspected metastatic lesions
- Management
- Simple cysts (Category I and II) require no additional evaluation
- Fat containing solid lesions consistent with benign angiomyolipoma may be followed or biopsied
- Category IIF lesions should be followed
- Suspicious Renal Masses are resected surgically instead of biopsied (due to biopsy sampling error risk)
- References
- Hitzeman (2014) Am Fam Physician 90(11): 784-9 [PubMed]