Renal Cell Carcinoma
Management of small renal masses

Gerry (72 years old)

Gerry is a 72-year-old retired librarian. He loves reading so much, it was the perfect occupation for him. As a matter of fact, all those years working as a librarian were just a great excuse to read books all day.
About a decade ago, his left kidney was rendered non-functional as a consequence of diabetes. To make matters worse, a small renal mass was recently found in his right kidney.

Assessment summary:

  • Medical history:
    • COPD
    • Insulin-dependent diabetes
    • Non-functional left kidney
  • Blood work:
    • eGFR: 30 ml/min/1.73 m²
    • Hb: 11.1 g/dl (normal range: 13.6-17.7 g/dl)
  • Abdominal contrast-enhanced CT:
    • SRM in right kidney (3.5 cm)
    • Location: lower pole, exophytic growth
    • cT1a
  • No metastases
  • Biopsy SRM: indifferent, possibly RCC focus

Which option would you choose for this patient?