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Peer-reviewedCC BYCancers

Cystic Renal Masses: From Malignancy Probability to Risk-Adapted Management.

  • Chencan Fang1
  • Chenyi Ge1
  • Lijuan Yin2
  • Xin Lu1
  • Le Qu3
  • Hanzhong Zhang1
  • Yan Zhang1
  • Ying Liu1
  • Yu Fang1
  • Qinqin Kang4
  • Aimin Jiang1
  • Linhui Wang1
4 affiliations
  1. 1Department of Urology, Changhai Hospital, Naval Medical University, Shanghai 200433, China.
  2. 2Department of Pathology, Changhai Hospital, Naval Medical University, Shanghai 200433, China.
  3. 3Department of Urology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China.
  4. 4Department of Radiology, Changhai Hospital, Naval Medical University, Shanghai 200433, China.
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Abstract

Cystic renal masses (CRMs) encompass a broad spectrum of conditions ranging from simple renal cysts to cystic renal cell carcinoma. Their detection has increased markedly with the widespread use of abdominal imaging, raising concern about potential overtreatment: many complex CRMs treated surgically are ultimately benign, while some malignant lesions are low grade, localized, and follow a relatively indolent clinical course. Although the Bosniak classification stratifies malignancy probability, translating lesion characteristics into preoperative assessments of biological aggressiveness and patient-specific clinical consequences remains challenging. Drawing on published evidence and common clinical decision-making scenarios, this Perspective outlines the pathologic classification of CRMs, examines the limitations of the Bosniak classification, and discusses the prospects for and current barriers to the use of radiomics and artificial intelligence for benign-versus-malignant classification. With the dual objectives of differentiating benign from malignant lesions and assessing biological aggressiveness, we focus on individualized management strategies that integrate the probability of malignancy, potential clinical harm, and patient-specific factors. These strategies include conservative management, indications for surgery, and selection of surgical approach. The aim is to inform more standardized and precise diagnosis and management of CRMs.

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Cite

BibTeXRIS
BibTeX
@article{fang2026cystic,
  title = {{Cystic Renal Masses: From Malignancy Probability to Risk-Adapted Management.}},
  author = {Chencan Fang and Chenyi Ge and Lijuan Yin and Xin Lu and Le Qu and Hanzhong Zhang and Yan Zhang and Ying Liu and Yu Fang and Qinqin Kang and Aimin Jiang and Linhui Wang},
  journal = {Cancers},
  year = {2026},
  month = sep,
  doi = {10.3390/cancers18193095},
  url = {https://europepmc.org/article/MED/42882790},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Cystic Renal Masses: From Malignancy Probability to Risk-Adapted Management.
AU  - Chencan Fang
AU  - Chenyi Ge
AU  - Lijuan Yin
AU  - Xin Lu
AU  - Le Qu
AU  - Hanzhong Zhang
AU  - Yan Zhang
AU  - Ying Liu
AU  - Yu Fang
AU  - Qinqin Kang
AU  - Aimin Jiang
AU  - Linhui Wang
PY  - 2026
DA  - 2026/09/23
JO  - Cancers
DO  - 10.3390/cancers18193095
UR  - https://europepmc.org/article/MED/42882790
AB  - Cystic renal masses (CRMs) encompass a broad spectrum of conditions ranging from simple renal cysts to cystic renal cell carcinoma. Their detection has increased markedly with the widespread use of abdominal imaging, raising concern about potential overtreatment: many complex CRMs treated surgically are ultimately benign, while some malignant lesions are low grade, localized, and follow a relatively indolent clinical course. Although the Bosniak classification stratifies malignancy probability, translating lesion characteristics into preoperative assessments of biological aggressiveness and patient-specific clinical consequences remains challenging. Drawing on published evidence and common clinical decision-making scenarios, this Perspective outlines the pathologic classification of CRMs, examines the limitations of the Bosniak classification, and discusses the prospects for and current barriers to the use of radiomics and artificial intelligence for benign-versus-malignant classification. With the dual objectives of differentiating benign from malignant lesions and assessing biological aggressiveness, we focus on individualized management strategies that integrate the probability of malignancy, potential clinical harm, and patient-specific factors. These strategies include conservative management, indications for surgery, and selection of surgical approach. The aim is to inform more standardized and precise diagnosis and management of CRMs.
SN  - 2072-6694
ER  -