In this tumor board–style episode, Dr. Mark Ball of the National Cancer Institute leads a multidisciplinary discussion on evaluating and managing an incidentally discovered small renal mass. He is joined by Dr. Brandon Manley (urologic oncology, Moffitt Cancer Center), Dr. Raki Hannan (radiation oncology, UT Southwestern), and Dr. Rena McKay (GU medical oncology, UC San Diego), who walk through diagnostic considerations and treatment options for a healthy 64-year-old man with a 3 cm renal mass found on imaging for unrelated symptoms.
The panel reviews the role of renal mass biopsy, decision-making around partial nephrectomy, and when thermal ablation or active surveillance may be appropriate for select patients. They also discuss the expanding evidence for SBRT in treating primary renal cell carcinoma, as well as whether there is any role for systemic therapy in localized disease. The case concludes with postoperative considerations following a robotic retroperitoneal partial nephrectomy demonstrating low-grade clear cell RCC (pT1a, negative margins) and how these findings shape follow-up and adjuvant therapy decisions.
Contributors:
Dr. Mark Ball is an attending surgeon at the Urologic Oncology Branch of the National Cancer Institute and Associate Program Director of the Urologic Oncology Fellowship Program in Bethesda, Maryland.
Dr. Raquibul Hannan is the chief of the genitourinary radiation oncology service at UT Southwestern in Dallas, Texas.
Dr. Brandon Manley is a urologic oncologist at Moffitt Cancer Center in Tampa, Florida.
Dr. Rana McKay is a medical oncologist and associate professor at UC San Diego Health in California.
