Cystic Renal Masses: Individualizing Care Beyond the Bosniak Classification

Cystic renal mass (CRM) management should integrate malignancy probability, potential clinical harm, and patient-specific factors—beyond Bosniak classification—to reduce overtreatment of benign lesions and tailor surgery to biological aggressiveness.

• Many surgically removed complex CRMs are benign or low-grade; the Bosniak classification alone may lead to overtreatment.
• Individualized management integrates malignancy probability, clinical harm, and patient-specific factors.
• Conservative management and precise surgical selection should be considered based on risk assessment.

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