Q Need Answer

[furee]

a 55 YEAR old male smoker undergoes a physical examination and laboratory work up for a life insurance application.history and physical examination,including rectal examination are normal.blood count is also normal.but urinalysis reveals the presence of blood in urine(>20RBC/HPF).cystoscopy is negative.abdominal US reveals a 5cm solid mass in the upper pole of the left kidney,confirmed by CT scan.which one of the following is the most appropriate management?
1) CT scan guided percutaneous biopsy
2) retrograde pyelogram
3) repeat CT scan in 6 months
4) intravenous pyelogram
5) surgical resection

[Monsoonrain]

I think the answer is 1.CT scan guided percutaneous biopsy

This is a Clear cell type, renal cell carcinoma.

Risk factors:

1. adult polycystic disease,
   
2. acquired kidney cystic disease,
   
3. smoking (RR = 2.0),
   
4. obesity in women,
   
5. hypertension,
   
6. von Hippel Lindau disease (develops in 50%);
7. hereditary renal cell carcinoma without VHL,
   
8. tuberous sclerosis

[furee]

thanks Monsoonrain for your reply.i want to ask when solid mass is confirmed by US and CT.then why we donot choose the choice 5 surgical resection.please can u clear to me