A 60-year-old man has a strong family history of aortic aneurysms.

Comprehensive and Detailed Explanation:

For small renal masses (<4 cm), partial nephrectomy (nephron-sparing surgery) is the standard of care in patients who are surgical candidates. It preserves renal function and provides oncologic control.

Toronto Notes 2023 – Urology / Oncology:

“Small renal tumors <4 cm should be treated with partial nephrectomy. Active surveillance or ablation may be alternatives in poor surgical candidates.”

MCCQE1 Objectives (Urology > 59-2: Renal Masses):

“Candidates must manage small renal tumors with nephron-sparing surgery when feasible.”

MRI (A) is unnecessary after CT confirmation. Radiation (B) is not first-line. Surveillance (D) may be appropriate for elderly or frail patients, not this one. Ablation (E) is for high-risk surgical patients.

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