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Can anyone shed some light on a complex cyst with some internal echos and possoble partial septation

stonecoldonerob
Posts: 1
Joined: Apr 2011

I had a ct done on my back as I have had some back fusions and now am having pain again the ct scan show a cyst. I then had a renal sonogram that showed a complex cyst with some echos and possible partial septation. the size of the cyst was 2.7 x 2.4 x 2.5 cm's any help in explaining this would be great.

thanks,
Rob

sue406
Posts: 12
Joined: Sep 2010

I had an abdominal ultrasound more than three years ago that found a mass in my left kidney, about 2 cm in size. The doctor immediately ordered a CT scan with contrast dye, to determine if the mass might be cancerous. The CT scan was inconclusive -- the mass was considered solid in nature, but there was very little "enhancement" or blood-vessel activity. So the doctor followed up with an MRI, which again concluded that the mas we "indeterminate" in nature. The local urologist recommended surgery to remove all or part of the kidney, but I went to the Mayo Clinic for a second opinion.

The doctor there was not inclined to operate, saying the chances of cancer were 50-50 or less. The mass was described as a "multiloculated cyst," meaning it had multiple septations. It rated, at different times, as a Bosniak III or a Bosniak II-F -- you can find a lot of information online about the Bosniak scale, and should probably ask your doctor how your cyst would rate on this scale.

To make a long story short, I had a number of MRIs over a three-year period. A doctor who finds a mass is usually not going to tell you to ignore it. Did your doctor talk to you at all about the need for follow-up imaging to see if the mass changes?

My doctor recommended "watchful waiting," with surgery a likely possibility if the mass changed in size or in the level of enhancement when injected with dye. Slightly more than three years after the initial finding, I finally went ahead and had surgery because the mass was slowly getting larger. It was just under 3 cm when it was removed. Fortunately, it was a rare form of benign growth called a cystic nephroma.

If you read about renal masses online, you'll find that they are being discovered more often because of the increase in the use of ultrasounds, CT scans, and MRIs for other issues. While some are clearly cancerous, others -- like yours and like mine -- are merely suspicious and it's hard to know what the right path is for treating those types of masses. Surgery is a major step, so you should really try to get as much information from your doctor as possible.

If your doctor didn't tell you more about the cyst, what it might be, or what he/she thinks should be done to follow up, you should probably ask more about it. The doctor may feel that it's simply a cyst and thus isn't concerned about the potential it may be cancerous. You should ask what it would rate on the Bosniak scale, and you should ask if there should be any more followup down the road and if so, what type and how often. My MRIs were initally done at 3 months and then at 6 months and then 1 year -- until the cyst started getting larger.

In the end, I'm probably glad I had the surgery. There are a lot of people on these discussion boards who had masses similar to mine, and they were malignant. I'm very fortunate that mine wasn't. I'm also glad I didn't rush into surgery, as my local doctor recommended, because i was able to have a much less invasive type of surgery done at the Mayo Clinic and the recovery was much easaier.

I think you should try to do as much reading as you can about complex renal masses and talk with your doctor to find out more about the results of the sonogram and what the doctor's recommended course of action is.

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