Renal mass Referral Access Criteria

Referrers should use this page when referring patients to public adult urology outpatient services for renal mass.

Emergency referral
If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region.
Nil

Immediate referral
Immediately contact on-call registrar or service to arrange immediate urology assessment (seen within 7 days):
Renal malignancy confirmed Renal malignancy with suspicion of metastatic disease To contact the relevant service, see Clinician Assist WA: Acute Urology Assessment (external site)

Clinical indications for outpatient referral
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
Incidental renal mass on imaging Mass suspicious for malignancy Angiomyolipoma Intra-collecting system lesion Complex cystic lesion

Mandatory information
Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test in regional or remote areas or due to financial reason). This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.
History	Relevant history, onset, duration and severity of symptoms Current medication list Any known allergies
Examination	Nil
Investigations	FBC U&E Urinary tract ultrasound (US) or renal ultrasound (US) or CT intravenous pyelography (IVP)

Highly desirable
History	Nil
Examination	Nil
Investigations	LFT Ca Staging CT scan of chest/abdomen/pelvis

Indicative clinical urgency category
Category 1 Appointment within 30 days	Imaging showing any of the following: solid renal mass ≥ 4 cm intra-collecting system lesion complex cystic lesion ≥ 4cm in size bilateral solid mass
Category 2 Appointment within 90 days	Imaging showing any of the following: solid or complex cystic renal mass <4 cm without evidence of metastatic disease angiomyolipoma ≥ 4cm angiomyolipoma < 4cm in a female of childbearing age large symptomatic simple renal cyst
Category 3 Appointment within 365 days	No defined category 3 criteria

Indicative clinical urgency category

Category 1

Appointment within 30 days

Imaging showing any of the following:
- solid renal mass ≥ 4 cm
- intra-collecting system lesion
- complex cystic lesion ≥ 4cm in size
- bilateral solid mass

Category 2

Appointment within 90 days

Imaging showing any of the following:
- solid or complex cystic renal mass <4 cm without evidence of metastatic disease
- angiomyolipoma ≥ 4cm
- angiomyolipoma < 4cm in a female of childbearing age
- large symptomatic simple renal cyst

Category 3

Appointment within 365 days

Exclusions
Simple <10cm renal cysts (diagnosed by ultrasound (US) and/or CT scan)

Useful information
Nil

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Last reviewed: 29-04-2025

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