The true malignancy risk of Bosniak III cystic renal lesions: Active surveillance or surgical resection?

Abstract

The malignancy risk of Bosniak III renal lesions was 60% in our study. All Bosniak III lesions were of low Fuhrman grade with no evidence of progression. No patient in this study developed metastatic disease within the three-year followup period. Smaller (<4 cm) Bosniak III cysts were more likely to be malignant and lesion size should be taken into consideration when considering management of complex cysts. Active surveillance may be a reasonable option for Bosniak III cystic lesions, regardless of overall size, based upon their universal low grade and no patient developing metastatic disease.