Presentation
Complex left renal cyst on ultrasound. CT to assess.
Patient Data
Age: 55 years
Gender: Male
From the case:
Bosniak cyst - type IV
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non-contrast

Complex enhancing mass at the lower pole of the left kidney, with a necrotic center.
Case Discussion
Exophytic part solid-part cystic lesion in the lower pole of the left kidney. The solid components enhance.
The appearances are those of a type IV Bosniak cyst, 100% of which are malignant.
Image guided renal biopsy was performed. It was a renal cell carcinoma.
The patient declined treatment.