Case 2025: Manuel (expert opinion by G. Pignot)

Manuel, 72 years old, was a renowned architect known for blending modern design with Portugal's historical elements. His work can be seen throughout Lisbon, where contemporary buildings sit alongside those inspired by the country's past. Early in his career, the grandeur of the Jerónimos Monastery, with its intricate Manueline style, sparked his passion for architecture. Now retired, Manuel spends his days in a quiet home overlooking the same Tagus River that once inspired his work.

About a decade ago, Manuel’s left kidney was rendered non-functional as a consequence of diabetes. To make matters worse, a small renal mass (SRM) was recently found in his right kidney.

Assessment summary:

• Medical history:
  • COPD
  • Insulin-dependent diabetes
  • Non-functional left kidney
  • ECOG PS 1
• Blood work:
  • eGFR: 30 ml/min/1.72m²
  • Hb: 11.1 g/dl (normal range: 13.6-17.7 g/dl)
• Abdominal contrast-enhanced CT:
  • SRM in right kidney (3.5 cm)
  • Location: central in hilus, endophytic growth, near right renal vein
  • cT1a
• No metastases
• Biopsy SRM: indifferent, possibly RCC focus

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