Question

a 68-year-old man with flank pain, hematuria, an abdominal mass, and normal renal function is most likely to have which one one of the following diseases? polycystic kidney disease nephrolithiasis nephroblastoma testicular torsion renal adenocarcinoma

Explanation:

1. Analyze each option:

• Polycystic kidney disease: Often presents with progressive renal dysfunction over time, and while it can have abdominal masses (enlarged kidneys with cysts), the combination of normal renal function here makes it less likely as a primary consideration for a 68 - year - old with these acute - seeming symptoms.
• Nephrolithiasis (kidney stones): Usually presents with severe flank pain, but an abdominal mass is not a typical feature of uncomplicated kidney stones.
• Nephroblastoma (Wilms' tumor): It is a pediatric tumor, very rare in a 68 - year - old.
• Testicular torsion: Presents with testicular pain, swelling, and is not related to renal or abdominal mass in the context of the kidney.
• Renal adenocarcinoma (renal cell carcinoma): In older adults (like 68 - year - old), it can present with flank pain, hematuria, and an abdominal mass (due to the growing tumor in the kidney). And renal function can be normal in the early stages as the tumor may not have completely obstructed or damaged the kidney enough to cause renal dysfunction yet.

Answer:

renal adenocarcinoma (the option with the label "renal adenocarcinoma")