Urologic Oncology (Kidney, UTUC, Bladder, Prostate, Testis, Penis)

A 62-year-old smoker has a 3.2-cm enhancing exophytic lower-pole renal mass with normal contralateral kidney; best oncologic and functional management?

A 70-year-old with gross hematuria has CT urogram showing an enhancing bladder mass; next best diagnostic step?

A 58-year-old has PSA 9.2 ng/mL, Grade Group 2, cT1c, 3/12 cores positive; risk category?

A 35-year-old man with a painless testicular mass: AFP elevated, beta-hCG normal; most likely histology?

A 66-year-old with muscle-invasive bladder cancer (cT2N0) and GFR 70 mL/min; recommended perioperative systemic therapy?

A 59-year-old has a 5.5-cm enhancing right renal mass that is central/hilar; best surgical approach?

UTUC low-risk features include all EXCEPT:

Intravesical therapy of choice for high-grade T1 bladder cancer after complete TURBT?

Initial imaging for a painless testicular mass?

A 72-year-old with PSA 5.8, Grade Group 1, cT1c, 1/12 core 10% involvement; best management?

A 64-year-old with cT3a renal cell carcinoma, normal contralateral kidney; best management?

Common paraneoplastic syndrome of RCC causing hypercalcemia?

A 55-year-old presents with gross hematuria; cystoscopy shows carcinoma in situ (CIS); best intravesical agent?

Post-orchiectomy staging for seminoma limited to testis with normal markers; recommended abdominal/pelvic imaging?

A 60-year-old with cT2 prostate cancer, Grade Group 3, PSA 14; appropriate definitive options include which?

A 68-year-old with MIBC refuses cystectomy; bladder-preserving tri-modality therapy components?

Risk factor most strongly associated with bladder urothelial carcinoma?

A 46-year-old with a solitary 1.5-cm low-grade distal ureteral UTUC; kidney-sparing option?

Variant histology associated with poorer BCG response in NMIBC?

A 32-year-old with stage I nonseminomatous germ cell tumor post-orchiectomy with lymphovascular invasion; management options include?

Imaging hallmark suggesting angiomyolipoma rather than RCC in a renal mass?

A 74-year-old male with obstructive symptoms and incidentally found high-grade T1 bladder cancer post-TURBT; key next step before BCG?

First-line systemic therapy principle in metastatic clear cell RCC?

A 67-year-old with elevated PSA and prior negative MRI-targeted biopsy; next step for persistent suspicion?

Penile cancer with a palpable mobile unilateral inguinal node (cN1); recommended management?

A 58-year-old with a solitary 3-cm upper-pole low-complexity renal mass and significant comorbidities; nephron-sparing alternative to surgery?

Which bladder cancer T stage invades the muscularis propria?

Seminoma stage I typical current preferred approach in compliant patients?

A 63-year-old with high-grade UTUC and hydronephrosis; standard surgical management?

Imaging to assess bone pain in high-risk prostate cancer with elevated PSA?

A 71-year-old with BPH/LUTS and incidentally found low-grade Ta tumor; immediate post-TURBT instillation reduces recurrence with which agent?

Tumor thrombus into the IVC from RCC suspected; key preoperative imaging?

A 52-year-old with PSA 38, Grade Group 4, cT3b; preferred initial management?

Biomarker pattern most consistent with NSGCT with choriocarcinoma component?

A 69-year-old with CIS refractory to adequate BCG; bladder-sparing options include?

Positive surgical margin after partial nephrectomy for pT1a RCC; best next step?

Common complication to counsel after retroperitoneal lymph node dissection for testis cancer?

A 61-year-old with localized papillary RCC type 1; prognosis relative to clear cell?

Management for penile squamous cell carcinoma Tis (PeIN)?

After nephroureterectomy for high-risk UTUC, strategy to reduce bladder recurrence?

Which finding most clearly makes a patient INELIGIBLE for cisplatin-based neoadjuvant chemotherapy for MIBC?

After an uncomplicated TURBT for a low-risk papillary tumor, the timing of a single intravesical chemotherapy dose to reduce recurrence is best described as:

Which factor is a POOR candidate feature for bladder-preserving tri-modality therapy?

For T1 high-grade micropapillary bladder cancer after repeat TURBT confirms T1HG, the preferred oncologic management is often:

In high-risk UTUC where cisplatin is considered, the optimal timing of systemic therapy is:

A patient with VHL has multiple bilateral small clear cell renal tumors; recommended threshold to intervene to balance metastasis risk and renal preservation?

A Bosniak IIF cyst is found on CT; appropriate management?

Imaging shows a Bosniak IV cystic renal lesion; best treatment?

RCC with level II IVC tumor thrombus is suspected; the cornerstone surgical management is:

Primary clinical utility of percutaneous renal mass biopsy for a 2.5‑cm indeterminate mass?

Which Grade Group corresponds to Gleason score 3+4=7?

After radical prostatectomy with adverse features and rising PSA 0.23 ng/mL, best approach?

For high-risk localized prostate cancer treated with definitive EBRT, recommended ADT duration is typically:

In newly diagnosed prostate cancer, which scenario warrants a bone scan?

Node-positive (cN1 M0) prostate cancer managed non-surgically is best treated with:

Stage I seminoma post-orchiectomy; evidence-based adjuvant option for patients declining surveillance?

Stage IS NSGCT (rising markers after orchiectomy); preferred initial therapy?

Good-risk metastatic NSGCT first-line regimen?

Poor-risk metastatic NSGCT standard initial therapy?

In IGCCCG risk classification for testis cancer, which marker contributes to risk grouping?

Organ-preserving approach appropriate for T1a penile cancer without high-risk features?

Indication for partial penectomy over glans-sparing surgery?

Definition of castration-resistant prostate cancer (CRPC) requires:

After radical cystectomy, which patients are candidates for adjuvant nivolumab?

Role of diagnostic ureteroscopy in suspected UTUC includes:

In active surveillance of a small renal mass, which change most strongly triggers intervention?

Hereditary leiomyomatosis RCC (HLRCC) is associated with which tumor behavior?

Birt–Hogg–Dubé syndrome renal tumor profile typically includes:

Sarcomatoid differentiation in RCC implies:

Pure squamous cell carcinoma of bladder localized to muscle-invasive stage is best treated with:

For PI-RADS 5 lesion on mpMRI in biopsy-naïve patient, best next step?

Which is a CONTRAINDICATION to BCG instillation?

Immediate post-TURBT mitomycin should be withheld when:

Which scenario meets “BCG-unresponsive” criteria?

BCG‑unresponsive CIS, cystectomy declined; FDA‑approved bladder-sparing option?

In active surveillance for low-risk prostate cancer, which change most strongly prompts definitive treatment?

For solitary resectable RCC metastasis appearing 2 years after nephrectomy, management may include:

Current role of cytoreductive nephrectomy in metastatic RCC?

Blue‑light (hexaminolevulinate) cystoscopy in NMIBC primarily:

High‑risk features in T1 bladder cancer such as LVI and variant histology suggest:

After nephrectomy for high-risk clear cell RCC (pT3a, negative margins), adjuvant systemic option to discuss?

A 55-year-old with 2.8-cm enhancing renal mass planned for ablation; which pre-ablation step can alter management?

Classic triad of RCC includes hematuria, flank pain, and:

A 69-year-old with CIS responding to BCG completes induction and 1-year maintenance; standard surveillance includes:

Muscle-invasive bladder cancer with creatinine clearance 35 mL/min; cisplatin-ineligible. Bladder-sparing option?

Which imaging modality is preferred for initial staging of UTUC?

Variant bladder histology associated with positive margins and peritoneal spread risk, often favoring early cystectomy?

Optimal intravesical agent for intermediate-risk NMIBC to reduce recurrence (patient declines BCG)?

A 61-year-old with oligometastatic RCC to lung after disease-free interval; systemic options include IO/TKI. Which local approach can be curative in selected cases?

Primary tumor control in metastatic prostate cancer improves outcomes when?

A 38-year-old with stage I seminoma on surveillance; marker to follow is typically:

Growing teratoma syndrome after chemotherapy for NSGCT is characterized by:

Urachal adenocarcinoma most commonly arises from which location?

For clinically node-negative high-risk penile cancer (pT1b or higher), preferred nodal strategy?

In prostate cancer, which imaging best detects biochemical recurrence at low PSA after RP?

After partial nephrectomy, the most important predictor of long-term renal function is:

A 72-year-old with UTUC undergoes RNU; to reduce bladder recurrence risk, give:

PSA 7.8 ng/mL, GG2, PIRADS 3; patient prioritizes side-effect minimization. Evidence-based option?

Paraneoplastic erythrocytosis in RCC is mediated by overproduction of:

Most common histologic subtype of RCC?

In bladder cancer, a positive prostatic urethral margin after cystectomy suggests risk for:

Most important prognostic factor in localized RCC?

For cT1b (4.2 cm) exophytic posterior renal mass with normal contralateral kidney, preferred approach when feasible?

Bladder-preserving trimodality therapy surveillance requires:

For pT2N0M0 penile cancer after partial penectomy with negative margins, next step for cN0 groins?

Testicular microlithiasis in asymptomatic men without risk factors warrants:

Urothelial carcinoma with upper tract obstruction and impaired renal function; before radical therapy consider:

Chromophobe RCC typically shows which feature?

For MIBC, clinical factor predicting poor response to bladder preservation:

Male breast tenderness during ADT for prostate cancer is primarily due to:

Collecting duct (medullary) carcinoma of the kidney is characterized by:

After radical prostatectomy, which finding most strongly supports adjuvant (immediate) RT over surveillance?

For UTUC low-risk disease managed endoscopically, surveillance includes:

Classic metastatic sites for testicular germ cell tumors include:

Primary tumor of kidney most associated with TFE3 translocation?

In NMIBC risk models, factors increasing recurrence/progression include:

Which PSA kinetic after definitive therapy suggests recurrence?

For localized RCC <4 cm in elderly frail patient, which is reasonable?

Imaging choice to evaluate suspected bladder perforation after difficult TURBT?

For organ-confined prostate cancer treated with EBRT, when is brachytherapy boost commonly considered?

Which finding is a contraindication to orthotopic neobladder at cystectomy?

Best management for BCG-unresponsive high-grade T1 bladder cancer in a surgically fit patient?

Prostate cancer adverse pathologic feature most strongly indicating high recurrence risk after RP?

In UTUC, which radiologic sign suggests invasive disease?

For low-risk prostate cancer on active surveillance, the most important follow-up test is:

A 3.8-cm posterior interpolar renal mass with RENAL score low; healthy contralateral kidney. Preferred approach?

For metastatic hormone-sensitive prostate cancer low-volume disease, optimized systemic backbone is:

Half-life kinetics indicating inadequate decline after orchiectomy for NSGCT:

Which is the most common site of distant metastasis in testicular germ cell tumors?

In bladder cancer, variant histology most associated with poor response to intravesical therapy and early progression?

Renal mass showing macroscopic fat and intralesional hemorrhage without calcification; most likely diagnosis?

Appropriate first-line for metastatic non–clear cell papillary RCC with measurable disease?

Indication to omit neobladder and choose ileal conduit diversion?

In cT1 renal mass active surveillance, which factor predicts progression requiring treatment?

Best next step for high-risk MIBC patient after neoadjuvant cisplatin-based chemo with partial response?

Prostate biopsy shows intraductal carcinoma (IDC-P) with high-grade invasive cancer; implication?

After TURBT, which factor defines “adequate BCG” exposure in assessing BCG-unresponsive disease?

A young man with a painful, enlarging testis and fever; ultrasound shows hyperemia and intact blood flow. Most likely diagnosis?

Key preoperative step to reduce positive margins in partial nephrectomy?

Adverse feature predicting poor prognosis in UTUC pathology after RNU?

Which patient with localized prostate cancer is best for brachytherapy monotherapy?

For renal mass suspected oncocytoma on biopsy, management may include:

For localized penile cancer requiring partial penectomy, margin recommendation is typically:

Tumor markers for seminoma should show which pattern?

Patient post-RNU for UTUC has bladder recurrence risk highest when:

Imaging finding more suggestive of oncocytoma than RCC?

In mCRPC progressing on abiraterone, next evidence-based systemic option includes:

A 2-cm renal mass with homogeneous low T2 signal and spoke-wheel enhancement pattern suggests:

For variant histology bladder cancer (squamous, adenocarcinoma), intravesical therapy role is:

After RP, biochemical recurrence is best defined as:

Optimal management of localized urachal adenocarcinoma?

Imaging modality of choice to evaluate retroperitoneal nodes in testicular cancer staging?

Which factor supports immediate cystectomy over BCG in T1 disease?

In prostate MRI, PI-RADS category primarily reflects:

For T1a penile cancer with high-grade features and lymphovascular invasion, groin management should include:

Post-nephrectomy surveillance for pT1 RCC typically includes:

Which mutational syndrome associates with bilateral pheochromocytoma and hemangioblastomas plus RCC?

Optimal management for pT2N0 penile cancer with negative margins and negative nodes after staging?

RCC subtype most associated with 3p loss and VHL gene inactivation?

For cT2b prostate cancer with high-risk features planning EBRT, a proven method to improve biochemical control is:

Lynch syndrome is most strongly associated with which urologic malignancy?

After neoadjuvant chemotherapy for cN2 penile cancer, nodes shrink to cN0; best next step?

Which feature favors kidney-sparing segmental ureterectomy for UTUC?

Nonmetastatic hepatic dysfunction (Stauffer syndrome) in RCC is mediated by:

For Stage II seminoma (retroperitoneal nodes ≤5 cm), a standard initial approach is:

Post-chemotherapy residual mass >1 cm in NSGCT with normalized markers; recommended management?

First-line therapy for collecting duct (medullary) carcinoma of kidney?

In prostate cancer after definitive radiotherapy, biochemical failure is defined as:

Which factor most supports performing an extended pelvic lymph node dissection at radical prostatectomy?

Optimal timing of PSMA PET/CT in biochemical recurrence after prostatectomy is when:

For RCC involving upper pole without adrenal involvement on imaging, adrenalectomy at radical nephrectomy is:

Classic complication to counsel after radical cystectomy with ileal conduit is:

For BCG-related systemic symptoms with suspected sepsis, initial management includes:

Which NMIBC risk profile is appropriate for single immediate postoperative intravesical chemotherapy only (no maintenance)?

A 4.5-cm hilar renal mass with high RENAL score and solitary kidney; best oncologic-functional plan?

Most common site of urethral recurrence after orthotopic neobladder in men is:

Optimal pathologic staging margin for partial penectomy to balance control and function is:

For oligometastatic prostate cancer progressing on ADT, a role for metastasis-directed therapy is:

Most predictive adverse feature for progression in high-risk NMIBC despite BCG?

Evidence-based adjuvant therapy following nephrectomy for non–clear cell RCC pT2N0 without high-risk features?

For UTUC treated endoscopically, an adjuvant topical option delivered via nephrostomy is:

In patients receiving IO/TKI for metastatic RCC, a classic immune-related adverse event to recognize is:

Definition of node-positive penile cancer (cN2) includes:

Which scenario supports early salvage RP after radiotherapy for localized prostate cancer?

In RCC, presence of rhabdoid or sarcomatoid features signifies:

For high-risk prostate cancer, adding brachytherapy boost to EBRT can:

Standard first-line systemic therapy for mCRPC (no prior ARPI) includes:

Role of 177Lu-PSMA-617 therapy is best described as:

Urachal adenocarcinoma commonly metastasizes to:

A 2.2-cm enhancing renal mass in a frail 88-year-old with eGFR 42 and multiple comorbidities; reasonable management?

Which histology of RCC most often presents with eosinophilic cytoplasm and Hale’s colloidal iron positivity?

For BPH and low-grade Ta NMIBC coexisting, the timing of TURP relative to TURBT when both needed is often:

After partial nephrectomy, early postoperative hemorrhage with collecting system leakage suggests:

Bladder-preserving complete response after chemoradiation; surveillance includes: