A slightly more suspicious score is a Bosniak 2F, which will be malignant 5% of the time.
They may or may not be followed based on the clinician’s judgment. A Bosniak 2 cyst has a less than 1% chance of being malignant. It is the intermediate grade complex cyst that requires judgment and counseling as to proper next steps. A Bosniak 4 cyst is considered an enhancing renal mass and must be assumed to be malignant and thus treated accordingly. A Bosniak 1 cyst is a simple cyst and would not be followed. This scoring system uses specific characteristics of the cyst like wall thickness, internal septations, calcifications and whether the cyst “enhances” to generate a score that predicts malignancy risk. A CT scan with IV contrast is mandatory if at all possible in such circumstances so that the Urologist can assign a “Bosniak score”. However, some cysts can be classified as “complex”, and such cysts do carry some risk of malignancy. Such cysts are called “simple” cysts and are usually definitively diagnosed with ultrasound or a CT scan with IV contrast. Kidney cysts can be very normal findings, and if they have no suspicious characteristics may not require further treatment or even to be followed. Kidney cysts can be very normal findings, and if they have no suspicious characteristics may not require further treatment or even to be followed.ĭuring a consultation, where a patient must bring his/her actual scan on disc for review by us, the first thing to determine are the characteristics and appearance of the kidney lesion.
It is important to remember however that many masses or suspicious lesions may not need to be removed, may not be cancerous, and even if cancerous are usually cured with removal alone. It is of course very scary to be told that by accident a mass or lesion has been found on one’s kidney, and almost always in such a circumstance a patient will be referred for counseling or perhaps even surgery to remove the mass. The incidental discovery of a mass on the kidney has become a commonplace occurrence now that imaging modalities such as ultrasound, MRI and particularly CT scanning is so prevalent.