OpenOnco · Workup Brief · DIAGNOSTIC PHASE

Pre-tumor-board workup brief

DPLAN-PZ-DIAG-RCC-001-V1 · v1 · 2026-05-12

Patient

PZ-DIAG-RCC-001 · suspicion lineage: renal_cell_carcinoma

Tissues: kidney, right_kidney · Hypotheses: DIS-RCC

64M presents to spine clinic for chronic non-radicular low_back_pain × 6 months. Lumbar MRI without contrast was unrevealing (mild facet arthropathy). Subsequent CT abd/pelvis with contrast (added per radiologist suggestion to rule out occult cause) revealed incidental_renal_mass — 5.4 cm contrast-enhancing right_kidney upper-pole lesion, exophytic component, possibly involves renal sinus fat (need MRI for staging). RENAL nephrometry score 9 (intermediate complexity). No regional LAD, no IVC tumor thrombus on CT, no liver/lung mets seen. CBC + CMP normal except mild microscopic hematuria on UA. No flank pain, no hematuria, no constitutional symptoms — classic incidental RCC presentation. eGFR 76 (preserved). Smoker × 30 pack-years (recent quit 2 years ago). Suspicion strongly favors RCC.

Workup steps (7)

1other Baseline renal imaging (CECT abdomen / MRI)
2imaging Contrast-Enhanced CT Chest/Abdomen/Pelvis
Initial staging imaging для більшості hematologic malignancies — лімфаденопатія mapping, organomegaly, extranodal involvement. Часто replaced by PET-CT для definitive lymphoma staging, але CECT доступnoша для початкового workup.
3lab Complete Blood Count with Differential
Baseline cytopenia assessment and ongoing monitoring of myelosuppression.
4lab Comprehensive Metabolic Panel
Електроліти (Na, K, Cl, HCO3), креатиnoн + BUN (renal function), глюкоза, кальцій, альбумін, total protein. Базова метаболічна оцінка перед будь-якою терапією + основа TLS risk + dosing adjustments.
5lab Liver Function Tests
Assess hepatic function — baseline + during BR cycles + DAA therapy + HBV reactivation monitoring.
6lab Renal function panel with eGFR (creatinine, BUN, electrolytes)
Baseline renal function before iodinated contrast, nephrotoxic systemic therapy, partial vs radical nephrectomy planning, and HRR / cisplatin eligibility.
7lab Lactate Dehydrogenase
Tumor burden surrogate; rising LDH suggests transformation or progression in indolent lymphoma.

MDT brief

MDT talk tree (3 steps)

#	Owner	Topic	Action
1	pathologist	Specialist review	Any suspicion requires biopsy — pathologist plans site selection, IHC panel, ancillary tests.
2	radiologist	Specialist review	Stage / restaging imaging + biopsy guidance — radiologist.
3	surgical_oncologist	Specialist review	Suspected solid tumor — resectability assessment, biopsy approach.

Skills (required) — mandatory virtual specialists (2)

Pathologist (general) required
Any suspicion requires biopsy — pathologist plans site selection, IHC panel, ancillary tests.
Radiologist required
Stage / restaging imaging + biopsy guidance — radiologist.

Skills (recommended) — for consideration (1)

Surgical oncologist recommended
Suspected solid tumor — resectability assessment, biopsy approach.

Technical MDT skill metadata (3/16 activated in this plan)

All registered virtual specialists. ✓ — activated for this case; ○ — not activated (available for other clinical scenarios).

Specialist	skill_id	Version	Last reviewed	Domain
Cellular therapy specialist (CAR-T)	`cellular_therapy_specialist`	v0.1.0	2026-04-25	cellular_therapy
Clinical pharmacist	`clinical_pharmacist`	v0.1.0	2026-04-25	clinical_pharmacy
Hematologist / oncohematologist	`hematologist`	v0.1.0	2026-04-25	hematology_oncology
Hematopathologist (lymphoma / leukemia / myeloma)	`hematopathologist`	v0.1.0	2026-04-25	hematopathology
Infectious disease / hepatology	`infectious_disease_hepatology`	v0.1.0	2026-04-25	infectious_diseases
Medical oncologist (solid-tumor chemotherapist)	`medical_oncologist`	v0.1.0	2026-04-25	solid_oncology
Molecular geneticist / molecular oncologist	`molecular_geneticist`	v0.1.0	2026-04-25	molecular_oncology
Palliative care	`palliative_care`	v0.1.0	2026-04-25	palliative_care
Pathologist (general)	`pathologist`	v0.1.0	2026-04-25	pathology
Primary care / family physician	`primary_care`	v0.1.0	2026-04-25	primary_care
Psycho-oncologist	`psychologist`	v0.1.0	2026-04-25	psychosocial
Radiation oncologist	`radiation_oncologist`	v0.1.0	2026-04-25	radiation_oncology
Radiologist	`radiologist`	v0.1.0	2026-04-25	diagnostic_imaging
Social worker / case manager	`social_worker_case_manager`	v0.1.0	2026-04-25	psychosocial
Surgical oncologist	`surgical_oncologist`	v0.1.0	2026-04-25	surgical_oncology
Transplant specialist (BMT)	`transplant_specialist`	v0.1.0	2026-04-25	cellular_therapy

plan_id: DPLAN-PZ-DIAG-RCC-001-V1 | version: 1 | generated: 2026-05-12T18:41:26.947469+00:00

Per FDA non-device CDS positioning (CHARTER §15): Diagnostic-phase MDT support: structure the workup, identify the team, surface unresolved questions. Not a medical device; not a treatment plan.

Per FDA non-device CDS positioning (CHARTER §15): DIAGNOSTIC PHASE — this output describes diagnostic workup only. Treatment plan generation is blocked until histology is confirmed (CHARTER §15.2 C7). Do not treat on suspicion.

This document is an informational resource supporting tumor-board discussion (per CHARTER §11). It is not a system that makes clinical decisions. Every recommendation must be verified by the treating physician.