A 60-Year-Old Man Comes to the Office Due to Dark

A 60-year-old man comes to the office due to dark, rusty-colored urine for the last 2 weeks.  He reports no pain, urinary frequency, or urgency.  The patient has no chronic medical conditions and takes no medications.  He smoked a half pack of cigarettes daily for 10 years but quit 30 years ago.  His father had hypertension and his mother has Alzheimer dementia.  Urinalysis shows a large number of red blood cells.  Renal ultrasound reveals a mass in the right kidney.  Cytologic evaluation of the mass shows malignant cells with a chromosome 3p deletion.  The deletion most likely involves which of the following genes?

A) c-MYC
B) NF-1
C) RB
D) VHL
E) WT-1

Correct Answer:

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