3.8 mm mass found on kidney with ultrasound

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dh1972
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Date Joined Apr 2015
Total Posts : 51
   Posted 4/6/2015 8:05 AM (GMT -7)   
Hi all,

I've been having GI and acid reflux issues lately. I had an upper endoscopy which looked good my Dr. said although still waiting back on the tissue biopsies which is normal procedure.

However, he ordered an abdominal ultrasound and to my shock it showed a mass. I've been very scared to say the least. I'm almost 43 and male, fit, never smoked, never drank alcohol, eat very healthy, only drink water, exercise regularly with aerobics and weight training, etc. and have never had a health issue before. No kidney cancer in family. I do suffer from some anxiety issues that started in 2013 after my father passed away at the age of 94.

I am getting a ct scan done on Wednesday.

I've also been having some side and lower back pains. But I also injured my lower back 25 years working out using barbell squats and then re-aggravated it about 5 months ago changing weights. I've also had some achy joints particular knees, but I was cycling 6-7 days per week for a stretch. I assumed all of this was because of overuse and injury, but I know I wonder. I've also had a very subtle low grade temp off and on for last 10 days from 98.6 to 99.5 at times. Sometimes it drops back to 98.3. I just had blood work done and everything is fine. Urine test was done a few weeks ago and normal.

Here is what the report stated in summary (see below
impression"). Any thoughts?

IMPRESSION:
3.8 cm heterogeneous mass within the inferior pole of the left kidney
demonstrating internal vascularity. This is concerning for malignancy.
Recommend correlation with dedicated contrast-enhanced CT.

Post Edited (dh1972) : 4/6/2015 9:12:27 AM (GMT-6)


Bay Area Guy
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Date Joined Jul 2010
Total Posts : 296
   Posted 4/6/2015 7:25 PM (GMT -7)   
The CT scan should definitely tell your doctor how suspicious the mass is. The other symptoms you describe can be related to a lot of different things, including stress. Most masses of the kind that you are describing are found when the doctor is looking for something different. Early stage kidney cancer really has no symptoms. I have a 1.5cm lesion on my right kidney that my urologist is monitoring. It was uncovered when a routine physical found microscopic amounts of blood in my urine (which has since disappeared). The urologist is not convinced it's malignant, and he said that waiting doesn't really run any risks as this is considered a low grade, very slow growing cancer. I have an appointment for a CT scan later this month and will see the doctor in early May to see what's happened in the last six months.

When I got the results of the first CT scan showing the lesion, I felt like you, so I did a lot of research and asked about 10 million questions. From what I can gather, a lesion up to 7cm in length is still considered Stage 1 renal cancer (assuming it's malignant). There are a variety of treatments for it. That includes removal of all or part of the kidney, either through traditional surgery or keyhole surgery (since I can't spell laperoscopic to save myself) and some pretty new techniques called radio frequency ablation and cryoablation where the tumor is either cooked (RF) or frozen (cryo) by little needles that get inserted into the kidney. My urologist is at Stanford and he thought that cryo would work just fine for me if I wanted it.

The important thing to know is that it was discovered early and, given that, the prognosis is for something like a 99% chance of full recovery.

Good luck!

dh1972
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Date Joined Apr 2015
Total Posts : 51
   Posted 4/9/2015 5:42 AM (GMT -7)   
Thank you!

The abdominal contrast CT scan showed the same mass as "suspect". 4.3 x 3.3 cm. According to my general doctor who read the CT report (as this test was ordered by my GI Dr) there is no indication the mass spread nor is it by lymph nodes, etc. I am seeing the urologist today about it. I will let you know what he says. I am going to get a second opinion as well. So far, it sounds promising all things considered. I would really like to keep the kidney if they can just remove the mass, but we'll see what they say.

My general doctor says it's so weird this happened to me at my age as I don't have Kidney cancer in my family (assuming it is cancer). I guess it makes me more prone to develop cancer in general which will require more frequent and earlier screenings for other things (colon cancer, etc.).

Bay Area Guy
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Date Joined Jul 2010
Total Posts : 296
   Posted 4/9/2015 7:44 AM (GMT -7)   
Good news about the non-spread of the mass. That pretty much means it's a stage 1 cancer (if it's, indeed malignant) and that means pretty straight-forward treatment. At the size you were quoted, the urologist may decide to monitor the mass for a while to see if it increases in size. That's what my urologist decided we should do. I asked him if that would present any potential for spread and he assured me it did not, but my mass is about 1/4 your size. So, if he suggests monitoring, ask if that means the mass could spread. My urologist also told me that if I psychologically couldn't handle the thought of possibly having a malignant mass inside me, he would take it out, but he didn't want to reduce my kidney function if he didn't have to. I checked with my sister. She's a nurse practitioner. That her field is neurology didn't matter as she's about the smartest person I know. She told me the same thing. So I decided to monitor it for a while.

Some things to make sure you get from the urologist:

1. How certain is he that the mass is malignant?
2. If he recommends monitoring, what is the chance of it spreading if it is malignant?
3. If he recommends getting the mass out, what are the options? Are the ablation techniques available for you and how effective are they at preventing a recurrence?

I'm not so sure having this form of cancer (and I keep reiterating IF it is cancer) means that you're more prone to get other kinds. That would be a good thing to ask.

Good luck with your urologist!

dh1972
Regular Member


Date Joined Apr 2015
Total Posts : 51
   Posted 4/9/2015 5:40 PM (GMT -7)   
Met with the Urologist. He does not specialize in this particular issue, so is handing off to someone who does - and my case will be presented to a board of doctors who meet weekly on these kind of issues - so a determination and recommendation will be made. The urology center I went to is part of a well-known, well reputable institute of a large hospital in the area.

My Urologist says he has seen a number of people my age with such masses that are NOT cancerous. He says the older you are, the more likely it is cancerous. I believe he said it could be a oncocytomas mass.

He thinks they will probably recommend a biopsy. I raised my concern about the risk of them, but he said they have really improved. If is cancerous, he thinks it would be a partial removal of the kidney given the mass is something like half way in and half way sticking out. The guy that would do the surgery is said to be outstanding and did 170 of these surgeries one year. My urologist said if he personally needed this surgery, this would be the guy.

But, we'll see what they recommend.

So, all in all, either way how it turns out, I feel a bit better about things but still on edge.

Post Edited (dh1972) : 4/9/2015 6:46:37 PM (GMT-6)


Bay Area Guy
Regular Member


Date Joined Jul 2010
Total Posts : 296
   Posted 4/10/2015 6:11 AM (GMT -7)   
Sounds similar to what my urologist said, although I have you by a few years. When I was first diagnosed with the lesion, my sister advised me against having a biopsy done, probably for much the same reason that you have misgivings. She said that with all the blood vessels in the kidney, a biopsy, if not done perfectly, could transport some material elsewhere. So, unless there's an overwhelming reason to have one, I think you should continue with your misgivings. My urologist never even suggested one.

I've seen quite a few doctors regarding this thing and I think I have a pretty good idea of what each specialty is going to say. Radiologists are going to say, "Well, there's something there; we don't know exactly what it is, so you should probably get it taken out." Urologists are going to say, "Well, there's something there; we don't know exactly what it is, so let's monitor it so we don't reduce your kidney function unnecessarily." And surgeons are going to say, "When do I cut? What was it again? Oh, never mind, I'll find something to cut out." My attempt at humor, but there does seem to be some truth in it.

Despite being on edge, try to keep doing your regular routine. I found that working out really helps me relax and put this stuff out of my mind, at least for a while.

dh1972
Regular Member


Date Joined Apr 2015
Total Posts : 51
   Posted 4/10/2015 6:39 AM (GMT -7)   
I'm going to talk to my general doctor today about it whom I really trust. He told me last week they don't do biopsies very often. The Urologist was also going to give him an update. My general doctor gave me the impression they will just want to take it out - and that could still happen for all I know. The Urologist said they don't want to put me through a surgery unless it's really needed. I guess another option might be to sit and wait to see if it grows, but I almost feel more comfortable with a biopsy as he said they are much better these days.

Yeah, I need to start working out again. I took some time off work too dealing with all of this. I need to figure when I am going back - I just couldn't focus on work with all of this coming on as it did. It made me a nervous wreck to be honest although I am feeling a bit better.

I also have a tooth that might need extraction, but that is minuscule in comparison, of course.

dh1972
Regular Member


Date Joined Apr 2015
Total Posts : 51
   Posted 4/10/2015 6:42 AM (GMT -7)   
Here is Mayo Clinic's Risks of biopsy. They seem to think they are generally safe.

http://www.mayoclinic.org/tests-procedures/kidney-biopsy/basics/risks/prc-20018979

dh1972
Regular Member


Date Joined Apr 2015
Total Posts : 51
   Posted 4/10/2015 12:29 PM (GMT -7)   
Scheduled for the biopsy on Wed morning.

dh1972
Regular Member


Date Joined Apr 2015
Total Posts : 51
   Posted 4/10/2015 1:26 PM (GMT -7)   
http://www.renalandurologynews.com/the-role-of-renal-tumor-biopsy/article/280356/

Bay Area Guy
Regular Member


Date Joined Jul 2010
Total Posts : 296
   Posted 4/10/2015 4:54 PM (GMT -7)   
Best wishes for the biopsy. I'll be here when you get the results.

dh1972
Regular Member


Date Joined Apr 2015
Total Posts : 51
   Posted 4/11/2015 9:17 AM (GMT -7)   
Thank you.

erbob
Regular Member


Date Joined Jan 2010
Total Posts : 279
   Posted 4/11/2015 10:54 AM (GMT -7)   
Sounds like I have something slightly similar. I had two CT scans with contrast, two ureteroscopies, an ultra sound (within the last eight or nine months) due to pain in my left side and suspicious cytology resulst. Finally was decided that there is a small mass just South of the renal pelvis and the ureter. The mass will be removed but since it is so dang close to the renal pelvis, the Dr. cannot just remove the section of that ureter and reattach the two ends. So, this coming Tuesday 4/14, I will be having my left kidney, left ureter and bladder cuff removed via the laparoscopic procedure. The right kidney is in good shape so I have been pretty well assured that the one good kidney will be able to handle the load. The mass is considered "atypical" of cancer cells and this is my fourth (4th) encounter with malignancy of some type in the last thirty three years so I am getting kinda used to this stuff. Now I just have to grin and bear the aches and pains which I have been told should not be too bad since it is the "keyhole" procedure.
Good luck dh1972!
Bob, born 1936
Dx Jan 2010, Volume 51.345
Gleason 3+4=7, second opinion 4+3=7
Brachytherapy May 26, 2010 at Chicago Prostate Cancer Ctr
1st PSA 3 months after seeds 0.12
2nd PSA 6 months after seeds 0.24
3rd PSA 10 months after seeds 0.281
4th PSA 13 months after seeds 0.21
5th PSA 18 months after seeds 0.214
PSA 22 months 0.19
PSA 29 months 0.308
PSA 33 months 0.257
PSA 44 months 0.142

Bay Area Guy
Regular Member


Date Joined Jul 2010
Total Posts : 296
   Posted 4/11/2015 11:57 AM (GMT -7)   
Good luck to you bob. Keep us up on your recovery.

dh1972
Regular Member


Date Joined Apr 2015
Total Posts : 51
   Posted 4/12/2015 6:28 AM (GMT -7)   
All the best Bob. I'm sure it will work out fine.

erbob
Regular Member


Date Joined Jan 2010
Total Posts : 279
   Posted 4/12/2015 9:19 AM (GMT -7)   
I certainly will post the outcome of my "Key hole" procedure. Thanks!
Bob, born 1936
Dx Jan 2010, Volume 51.345
Gleason 3+4=7, second opinion 4+3=7
Brachytherapy May 26, 2010 at Chicago Prostate Cancer Ctr
1st PSA 3 months after seeds 0.12
2nd PSA 6 months after seeds 0.24
3rd PSA 10 months after seeds 0.281
4th PSA 13 months after seeds 0.21
5th PSA 18 months after seeds 0.214
PSA 22 months 0.19
PSA 29 months 0.308
PSA 33 months 0.257
PSA 44 months 0.142

erbob
Regular Member


Date Joined Jan 2010
Total Posts : 279
   Posted 4/13/2015 1:32 PM (GMT -7)   
Well, I guess I kinda lucked out. The hospital staff called me this afternoon and indicated that I'll be the very first one for the procedure. Need to be checked in by 0530 in the morning. Sure glad to get this nasty little "thing" removed.
Bob, born 1936
Dx Jan 2010, Volume 51.345
Gleason 3+4=7, second opinion 4+3=7
Brachytherapy May 26, 2010 at Chicago Prostate Cancer Ctr
1st PSA 3 months after seeds 0.12
2nd PSA 6 months after seeds 0.24
3rd PSA 10 months after seeds 0.281
4th PSA 13 months after seeds 0.21
5th PSA 18 months after seeds 0.214
PSA 22 months 0.19
PSA 29 months 0.308
PSA 33 months 0.257
PSA 44 months 0.142

Bay Area Guy
Regular Member


Date Joined Jul 2010
Total Posts : 296
   Posted 4/13/2015 3:14 PM (GMT -7)   
Best wishes for a swift recovery, both from the procedure and the lack of sleep.

Although first thing in the morning is great!

dh1972
Regular Member


Date Joined Apr 2015
Total Posts : 51
   Posted 4/13/2015 4:02 PM (GMT -7)   
Just a question. How long before one can go back to work after a partial removal of kidney (presuming it be done with laproscope)? My job is not physical.

Bay Area Guy
Regular Member


Date Joined Jul 2010
Total Posts : 296
   Posted 4/13/2015 4:26 PM (GMT -7)   
Absolutely no idea. You should check with your surgeon.

dh1972
Regular Member


Date Joined Apr 2015
Total Posts : 51
   Posted 4/16/2015 7:27 AM (GMT -7)   
Well, I had the biopsy yesterday. Rough day.

The procedure itself seemed to go fine, but I am very sore today. Slow to walk, cannot bend over, and hard to sleep last night because of the pain in that kidney area. I guess you are supposed to be pretty sore, but not sure if its this bad. The nurse contacted me today to see how I was and was going to check with the doctor. No signs of blood in urine or a hematoma. Temp normal too.

However, the worst part of it was when the nurse gave me an IV of Dilaudid right after the procedure. Maybe she gave me too much too soon, or just bad reaction to it as I never had it before. Immediately after, I felt extremely ill. It was the most awful, scary feeling of my life...I nearly passed out, blood pressure temporarily dropped to something like 80/30-something. I felt like I was going to die although they did not seem too concerned as they see this happen with this med with some people (which begs the question why it is used). It passed after several minutes, but then about 4 hours later when I tried to sit up it virtually happened again although maybe not quite as bad. The ended up send me to the ER at the hospital ran an EKG which was normal, gave me more fluids, etc. and I started to finally feel a bit better before going home. I think it takes up to 6 hours to wear off. I was also a bit dehydrated too which the IV started to help with that.

That was the first and only time I will ever take that stuff again. Horrible!

Anyway, this was a rougher procedure all the way around from what I was expecting.

Biopsy results should be in soon.

Bay Area Guy
Regular Member


Date Joined Jul 2010
Total Posts : 296
   Posted 4/16/2015 7:37 AM (GMT -7)   
Good that it's over with. It's strange because Dilaudid is one of the few pain meds that doesn't me go crazy(ier). When I had abdominal surgery, that's what was in the pain pump. I only had to use it a couple of times and, to be honest, it wasn't for pain, it was to help me sleep. The other pain meds they gave me resulted in a racing heart and blinding headaches. I guess everyone's body reacts to stuff differently.

Regarding the biopsy, yes, I think you'll be sore for a little while. Just take it easy for a few days and get waited on hand and foot. Take care.

Bay Area Guy
Regular Member


Date Joined Jul 2010
Total Posts : 296
   Posted 4/17/2015 6:11 AM (GMT -7)   
How you feeling today dh?

dh1972
Regular Member


Date Joined Apr 2015
Total Posts : 51
   Posted 4/18/2015 6:33 AM (GMT -7)   
I got the biopsy report and it came back benign. A big sigh of relief as one can imagine. I don't have a lot of details other than:
--- BENIGN RENAL CORTEX
--- NO NEOPLASM

I still have to discuss the next steps with my Urologist, but I believe they want to do an ultrasound in 4 months to see if it's growing or not as that can still cause complications if it gets too big. I have a 4mm polyp on my gallbladder that needs to be monitored anyway.

I am starting to feel a bit better although still in some pain. Certain angles really it where as others I feel fine.

I paid a visit to my general doctor just to look everything over and he said everything looked great, no signs of bleeding, wound looks really good, etc.

Bay Area Guy
Regular Member


Date Joined Jul 2010
Total Posts : 296
   Posted 4/18/2015 6:25 PM (GMT -7)   
Fantastic news! I'm happy it came back benign. Also sounds like you're on the road to a full recovery from the biopsy. Nice to hear something good. That made my day.

I go in for my followup Ct scan on the 28th and see my urologist on the 5th of May. I'm hoping to be able to report something similar, although I guess the best I would be able to say is no growth in whatever this is.
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