The Anatomy of a Question
Question
A 70-year-old man has a solid kidney mass identified on abdominal imaging performed for unrelated reasons. The radiologic features of the mass are concerning for malignancy. Which of the following is the classic triad for the most likely diagnosis?
Answer choice options
- A. Abdominal mass, ascites, and weight loss
- B. Abdominal mass, flank pain, and hematuria
- C. Flank pain, hematuria, and weight loss
- D. Flank pain, left-sided varicocele, and weight loss
The incorrect options (distractors) are not totally wrong. These options can be diagramed as follows:
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B.Abdominal mass, flank pain, and hematuria These three findings make up the classic triad for renal cell carcinoma.
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D.Flank pain, left-sided varicocele, and weight loss Weight loss and varicocele are not part of the triad, but scrotal varicoceles are present in up to 10% of individuals
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C.Flank pain, hematuria, and weight loss Weight loss is not part of the triad but may be a presenting symptom.
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A.Abdominal mass, ascites, and weight loss Ascites and weight loss are not part of the triad.
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