A 40-year-old male with a history of chronic alcohol abuse presents with haematuria and flank pain. A non-contrast CT scan of the abdomen reveals a large, hypodense mass in the right kidney with areas of necrosis. What is the most appropriate initial treatment? A) Intravenous antibiotics B) Renal biopsy C) Immediate nephrectomy D) Observation and follow-up imaging E) Palliative care referral Answer: C) Immediate nephrectomy Explanation: The presentation of a large, hypodense mass with areas of necrosis in the right kidney in a patient with a history of chronic alcohol abuse raises suspicion for renal cell carcinoma. The most appropriate initial treatment is immediate nephrectomy (Choice C) for both diagnostic and therapeutic purposes. Choices A (intravenous antibiotics), B (renal biopsy), D (observation), and E (palliative care referral) are not the primary interventions for suspected renal cell carcinoma.
