• CT scan (pre and post contrast to assess enhancement)

• Consider bone scan—if bone pain or hypercalcemia Renal cysts

• Usually incidental findings

• If simple (type I)—no further investigations needed

• If complex (type II or greater)—pre- and post-contrast CT scan is mandatory

• Risk of malignancy in Type III and IV is high (40-100%)

• Classified according to Bosniak:

■ Type I: simple cyst, no septa, no calcification

■ Type II: cyst with thin septa, no or fine calcification in the wall, wall/s do not enhance on post-contrast CT

■ Type IIF: Minimal thickening of septa or wall, coarse calci fication, no enhancing soft tissue elements

■ Type III: more like cystic masses, thick irregular walls or septa which enhance

■ Type IV: abnormalities are more obvious than in Type III

with more enhancing soft tissue lesions

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