What does a Bosniak Iv Renal Cyst Obscure?

Abstract

One of the challenges urologists encounter when dealing with renal cysts is distinguishing between benign and malignant cystic tumours. Approximately 5-7 percent of renal malignancies have a cystic appearance, and clear cell renal cell carcinoma is the most common histological type found (half of the cases), followed by papillary carcinoma. Specific management should be performed in accordance with the Bosniak classification stage. Stage IV is a form of complex cystic tumour with a high risk of malignancy. We report the case of a 51 year old patient, followed for gout, in whom a left renal remanent cyst, measuring about 8 cm, was incidentally discovered during a routine check-up on abdominal ultrasound and classified as Bosniak IV on CT urogram. A left Neohrectomy was performed, and a pathologic examination revealed papillary carcinoma, stage pT2a (intermediate risk according to the UISS). The short- and long-term outcomes were both satisfactory, with a normal CT TAP six months after surgery and normal renal function. To summarise, a Bosniak IV renal cyst needs special attention and full surgical excision to reduce the risk of malignancy progression nd survival is unquestionably satisfactory.