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Anyone had a kidney tumor biopsy?

LKidd
Posts: 37
Joined: Feb 2013

3 cm mass on left kidney (See previous "freak out" post) - 1st opinion was open kidney surgery, identify the tumor, take 1/2 or all the kidney dependent on tumor type. 2nd opinion is drastically different, but from a highly regarded doctor that has a lot of experience with kidney tumors. He thinks it's benign, most similar to benign tumors he has taken out. He also thinks it might be in the fatty tissue around the kidney, not on or in the kidney. He believes a biopsy is the best choice, watching it is 2nd, and surgery distant 3rd option. Everyone else told me a biopsy could spread a cancer if it is cancer. He thinks the risk is so low due to the location, and even if cancer the risk is super low. Totally different opinion.

Anyone had a kidney biopsy? Can you feel it? Painful? Apparently risks are bleeding, infection - anyone's experience following?

Still in limbo on decision - LKidd

Mimir
Posts: 24
Joined: Dec 2012

I  had a biopsy done (NIH clinical center). The doctors I talked to said that it used to be the view that biopsies could spread cancer and where bad, but the cutting edge studies show that there is  almost no risk from a biopsy. For my biospy I was awake lying on my stomach with a light sedative and some local anesthesia on my back. They used a large needle and took some samples.  For me, the  disconcerting  parts of the procedure were the clicking sound  the large needle made as it took samples, and blood trickling down my back. There was a bunch of bleeding but nothing that worried them.  After the biopsy you generally would go to thhe day hospital for observation(making sure there is no internal bleeding). The spot is sore for a few days, but after a week you should be fine. 

One of the main arguement against  biopsies is that different parts of the tumor can return different results. They told me that they were going to take 3 samples from diffrent parts of the tumor to make sure they got an accurate result. 

I would recommend getting the biopsy if, and only if, the procedure could significantly alter your treatment path.  SInce I am 18 years old, the docotrs thought I  might have a wilms tumor. The treatment for wilms tumor is chemo and surgery.  If the tumor had been wilms there would have been a good chance the doctors could have saved part of my kidney.  The small risk of the biospys was offset by the better outcome of knowing what type of tumor I had.

In other words, if you are going to get surgeyr to remove it either way, there might not be sense in getting a biopsy. If you still have doubts, bluntly ask your doctor what the difference in treatment would be with and without the biopsy.

I hope everything goes smoothly!

LKidd
Posts: 37
Joined: Feb 2013

Mimir - Hi, a couple questions about your biopsy - Aside the clicking noise, did it hurt? Painful? And afterwards how do they confirm there is no internal bleeding? Also, they are saying I will be on fetynal and versed (sp?), was that what you were on? If so, were you fairly sedated. When you went home, able to walk around and be normal, just sore? Or did your kidney/side hurt at all. I know you said you were sore, but how much? I had versed before and was very combative on it, a few times for a few endoscopies. I am concerned about how it feels, them damaging my kidney because my tumor is so thin (3/8" thick), how I will react during the procedure while sedated, I am sure you have to stay still, not sure if I will react and not stay still, the bleeding risk and how it feels afterwards. Wow, so many questions, but any more insight would be appreciated. Thanks so much again, to all who are posting, but since you have gone through it your experience will be helpful, and anyone else with the experience.

love_of_my_life
Posts: 28
Joined: Jul 2012

My wife had a biopsy last August before she had her entire kidney removed.

It was a fairly simple process and she was not in much pain.  I actually sat in the room while they did it using ultrasound to guide it.

You are in our prayers.  You will get through this.

Tom and Holly

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Texas_wedge
Posts: 2807
Joined: Nov 2011

The second opinion you got makes good sense to me and so does Mimir's analysis.  You've gathered that the procedure is nothing to be apprehensive about.

The expert consensus these days is that the likelihood of seeding new cancer by needle track in biopsy is negligible.  The main contraindication is the chance of a false negative result.  By taking several samples they will minimise the risk of that outcome in your case.

If the biopsy results bear out the intuition of your expert second opinion, then you will be spared unnecessary surgery and just continuing surveillance will be all that's needed.

love_of_my_life
Posts: 28
Joined: Jul 2012

I didn't supply as much information as I should have.

My wife's biopsy was an outpatient affair.  Depending on the tumor's position, they will probably determine weather to use an x-ray or ultrasound.  My wife pushed for the ultrasound since she had so many x-rays over the previous months and they agreed to do it.  Much of this will depend on the type of contrast they get to isolate the tumor.

After the doctor doing the biopsy and ultrasound tech determined the course, they numbed her using a shot of lidocaine.  She was entirly awake for the whole procedure.

The biopsy needle connects to a spring loaded device.  She was not in much pain when they went in with the instrument just a bit of discomfort.  Once the Dr. and ultrasound tech agreed that it was positioned correctly, he pulled a trigger and the device snapped a sample.  They did this three times which took right around 15 minutes.  We were home three hours later.

Your procedure may vary, but I wanted to get some details out there.

Tom

LKidd
Posts: 37
Joined: Feb 2013

First I want to thank all of you that posted. Your advice,  knowledge and experience helps so much. Each step I take with this is new, and when I hear 1st hand experiences and find out a lot of ppl on here have been there done that, it's so relieving.

So they called today to schedule the biopsy, which I expected. What I didn't expect is that apparently the radiologist that looked at the CT and was going to do the procedure said it was not safe to do a biopsy. He believes it has liquid in it, filled with liquid. If it was an infection of any kind or without knowing more about what it is, the biiopsy poses a risk and is unsafe. So he wants an MRI.

New turn, the mystery deepens. 1st open surgery probably cancer and tumor, to biopsy probably benign, to MRI it looks fluid filled. So far all that have looked at the CT say they have not seen a tumor like that before. Even my 2nd opinion doc who has seen and removed a million of them. So this is concerning, dragging out a little but at the same time might be good news. Not sure. So on to an MRI. Hopefully that will shed some light on what this little friend of mine is.

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Texas_wedge
Posts: 2807
Joined: Nov 2011

It's fascinating, though it must be a little unsettling for you.  Please keep us informed of every new twist and turn. 

It may turn out not to be too bad at all, at the end of all of this, even if you are a groundbreaker! 

LKidd
Posts: 37
Joined: Feb 2013

The mystery deepens. So I got the MRI today, see above for the summary of current status. But yes,, more of a mystery. I can't totally discern all of the MRI "Impression" but have done some research to get an idea. I will have my doc explain it in easy terms. But basically it is not fluid filled. So now it is definitely a mass. So now I am scheduled for a biopsy this next Tuesday 3/5. Yes, I will probably freak out over that, like I have mentioned - not good with any medical procedures. I did okay today on the MRI, but still so not comfortable with any medical stuff. So on to the biopsy.

The MRI impression report basically confirmed the mass, confirmed the adrenal gland having a lesion, it confirmed the size as it was in January, but for some reason showed a 2nd measurement on there. It was 3.4 cm on 1/1, this says 3/4 cm, but a second measurement on there shows 3.5 cm by 12.8 cm and I can't tell what that is regarding. It shows that my liver duct is dialated, not sure what that means. Everything else is normal i.e. pancrease, gall bladder, abdomen. The most concerning part is it shows fatty tissue loss between the mass and abdominal wall, then in the summary below it shows concern for RCC but can't exclude angiomyopiloma which is a benign tumor, but then specifies that angiomyopilomas do not invade the abdominal wall. What?! Something is invading my abdominal wall? And it could be RCC, but no one knows what my creature is. Wow.

Onward we go. Still not identified, hopefully we do the biopsy, identify it and know where we are going. I am nervous for the biopsy. I hope it causes no problems. I hope it really just doesn't hurt that much and we just get an answer. Hoping for a good answer.

In the mean time I will be getting my doc to decipher the MRI impression so I understand it.

Thanks again for your help. Anyone else with kidney biopsy experience I welcome your input. It really helps. This site is amazing.

todd121
Posts: 555
Joined: Dec 2012

Was your CT with contrast? I don't recall if you said.

I had thought these fluid-filled masses were usually considered cysts. I had also heard of a type of benign tumor they could be that is visible on a CT with contrast. I guess I'm familiar with what they would see with an MRI that they didn't see with the CT with contrast. If someone could explain, I'd like to hear about that. Even with the CT without contrast my doc was pretty sure I had RCC. Of course my mass was 6.8 cm. That's quit a bit larger than yours.

If the mass is a long way from blood supply or lymph, is waiting and watching an option?

Please update us after your MRI and tell us what it showed.

Todd

LKidd
Posts: 37
Joined: Feb 2013

Todd, Hi - the update for the MRI was posted right before your post. It's on to a biopsy next week. Originally Tuesday 3/5, now Monday 3/4. Not fluid filled. My doc was hoping the MRI with contrast would shed light, possibly identify it more and we could stop there and watch it as you mentioned because he still thinks it is benign, or make a decision on what to do if it's RCC. Check out the MRI resultts, still a mystery. Still odd, unique and no one has seen it. My doc did talk to me tonight. He still thinks it's benign. The biopsy will really help my situation. Thanks for your interest, I hope it's a friend too.

Patrick72
Posts: 14
Joined: Feb 2013

I actually just had a needle biopsy done two days ago. The worst part was laying in recovery and not being able to really move or sit up for the first two hours. The biopsy itself there was no pain. They are able to a tunnel of lidocaine all the way through to the kidney. When they told me it was over, I thought that they were still looking for the best way to get to the tumor. One thing that they did where I got it done was to fill the hole that the needle made with colagen as they were pulling the needle out to minimize bleeding. I have tp say I was impressed. I have had no pain and had no need for even a motrin or tylenol.

LKidd
Posts: 37
Joined: Feb 2013

Thanks for your experience. That helps. I was mostly worried about the pain of it, then the risk of bleeding. Sounds like you had a good doc. I appreciate the detail.

MDCinSC's picture
MDCinSC
Posts: 574
Joined: Feb 2013

Like you, I'm new to all this.

I had a contrast CT scan about two weeks ago for a stomach complaint. When they read it they discovered I have a 4cm mass in the lower right segment of my right kidney.  Well, that and a few stones in each kidney as well as one in the bladder.  I'm struggling with the VA to get me in for a Urology consult to see where we need to go with this.

Common sense says that the sooner I get in for the consult the better, but how long can I wait for the VA to move without really seriously risking negative consequences? Anybody have a thought?

I am striving  to maintain perspective on this.  Advice would be appreciated!  Thanks!

LKidd
Posts: 37
Joined: Feb 2013

Hi - How are you. It looks like your mass, only slightly larger than mine was also discovered incidentallly in looking for the stomach illness. Sounds familiar. Very. Mine is 3.4 cm. So in a nutshell, I went to my doc. He wanted his radiologist to confirm the mass which he did. They sent me to a Urologist. He never saw a tumor like mine before. He consulted with collegues. They got back to me and said open kidney surgery, identify it, remove 1/2 or all of the kidney. Well that was a lot to swallow. He was convinced it was renal cell carcinoma, because 80% of tumors are. I didn't like the extreme jump to conclusion. I researched and found a 2nd doc. He is very highly rated in the nation. I found him to be more confident and knowledgeable, plus he has taken a lot of kidney tumors out, seen them a lot and could tell me all the findings he has dealt with that were similar. He also has never seen one exactly like mine. He is really feeling like it's benign. He wanted a biopsy, and contrary to some belief that biopsy carry a risk of spreading cancer if it is cancer, he believes the risk is very very low, even if cancer very low, and still believes it's benign. Then the radiologist to do the biopsy felt it might have fluid in it, that would be too unsafe to biopsy. So I was sent for an MRI yesterday. That shows no fluid, same size still, and did not shed light on what it is. So my doc today said he is still feeling it's benign, and I go to biopsy Monday 3/4.

My advice - Definitely get it. Get evaluated. I would even seek 2-3 opinions depending on what they say and how comfortable you are with the opinions. I say get in because this process is taking a long time. The frustrating part is scheduling, procedures, appointments, more tests, more opinions. This all takes time. Meanwhile for me 2 months have gone by. These do grow, although slow, the earlier you catch and treat the better your outcome and chance for full recovery. So get the process going. Each step I go to support on this site. It is really awesome. Total strangers sharing the same experience of what you are about to go through. Some in the same place, some much worse off, some recovered or healed, so many stages. But it's really helped me deal with the next hurdle. So I would get going on it, and stay in touch and really reap the support here from the very unselfish people on here willing to share and support you.

Lkidd

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garym
Posts: 1651
Joined: Nov 2009

MDC,

First, welcome to the club nobody wants to join.  At 4.0cm your tumor is still quite small (golf ball size) and RCC is very slow growing so you have time to clarify your situation and make a decision as to how to proceed.  Some type of surgery is likely so start getting used to the idea and prepare yourself physically if need be.  You will have options like open, lap, robotic, full, or partial, find a good medical team that you are comfortable with and trust and follow their recommendations.  Mine was similar in size, it has been 40 months for me and likewise you are going to be fine.  Take a deep breath and calm yourself, be persistent, but not desperate, do some research and prepare a list of questions for when you do start seeing doctors.  Keep us posted, we're here to help.

Good luck and Godspeed,

Gary

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MDCinSC
Posts: 574
Joined: Feb 2013

Great Welcome All!  I appreciate it.

I am definitely following through with every step.  I am compelled to deal strictly with the Veterans Administration on this since health insurance is a luxury I haven't been able to afford.  Medicare isn't an option for a few more months, and I am not comfortable waiting that long.

I have a great primary care physician who is ram-rodding this through the bureaucracy and ensuring I get good care quickly.  He is quite a find here.  We're still waiting for a urologist appointment to confirm but operating under the assumption that things are that serious.  Who knows, perhaps there is a big sigh of relief at the end of this but I'm still holding my breath.

How do you deal with the frustration and the occasional anger?  Last night was especially hard.  I am usually far more in control of myself than that.  Especially since there is no one to really be angry with! LOL  We humans are a funny breed!

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garym
Posts: 1651
Joined: Nov 2009

MDC,

The emotional roller coaster is normal and just part of the ride and remember it is just as hard on those that are close to you, but they feel the need to be understanding and put up a strong front which complicates things.  That's part of the reason we are here, feel free to holler, scream, and rant here, we understand and you can't hurt our feelings.  You'll still need to vent and cry in the real world, but many of us have benefited from taking the edge off on the understanding shoulder found here.  You may find that these feelings intensify after they pronounce you "cured", it can take your mind longer to come to terms with the whole cancer ordeal than it takes for your body to mend, and that's OK too.  You are in a whirlwind right now and it can take many weeks or months for things to return to "normal" again.  We're here whenever you need us.

Hang in there,

Gary

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MDCinSC
Posts: 574
Joined: Feb 2013

Thak you Gary! 

I was so relieved to find this place after so much looking.  There are others that seem to be nothing more than sinkholes to gather information and sell something!  I feel more and more this is the right place to be!

 

I appreciate your reaching out!

MDC (Mike)

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Eims
Posts: 414
Joined: Feb 2013

Hi Mike,

I am sure everyone here knows exactly how you are feeling.  It is completely natural and there are plenty of people to help you through this.  This is a great place to vent and get some information.  I just wanted the tumor gone and I have to say so far so good and we are all stronger than we think we are.

Eims

 

MDCinSC's picture
MDCinSC
Posts: 574
Joined: Feb 2013

Update!

I have my urologist appointment Monday!  They sure got me in fast! Gotta love when bureaucracy works!!

I'll be hanging around reading and cheering!

Mike

LKidd
Posts: 37
Joined: Feb 2013

Awesome Mike! Positive movement. As others said, please do rant and rave, and celebrate too here with us. Everyone is in different stages of this roller coaster. I am glad you got your appointment, I hope it goes well. Keep us posted.

My biopsy is Monday. I am worried. I hope it goes well. I got some feedback but not sure completely what to expect really. I hope that goes well also. Concerned about risks of bleeding, how I will feel afterwards, concerned because my tumor is flat and small and only 3/8" thick, how are they going to get some of it without damaging my kidney etc. etc. too worried. I will update of course. If anyone else has experience with biopsy it would be great to hear about it. :)

Thanks to everyone for the support!

Texas_wedge's picture
Texas_wedge
Posts: 2807
Joined: Nov 2011

I'm afraid I can't speak from personal experience (there was no doubt in my case, so I just had two open ops).

However, may I make a suggestion?  You are plainly very anxious and, even though you are getting some reassuring feedback here from folks who have had a biopsy, your situation is a little different with your special wafer lesion.

In your shoes, I'd be asking the questions you're putting to us here directly to the experts - the people who will be conducting the biopsy.  They will have done numerous such procedures, they're aware of your unusual tumor (?) and will know how they intend to proceed.  Now would also be a good time to alert them to your past combativeness so that they can accommodate that, if they need to.

I think you are worrying more than you need to and all will be fine but to hear that from the experts will be a lot better and I'm confident they will be able to answer all of your questions with complete and comforting answers.

All will go fine on Monday and we'll await the next instalment of the mystery story with interest, reckoning there will be a happy ending quite soon.

LKidd
Posts: 37
Joined: Feb 2013

Thanks TW, yes, as you noted anxious. I do plan on posing all these questions to the docs. I agree, they have done a lot of these and can likely accommodate and hopefully it will be fine. I have my list of questions ready to go! Thanks again, my mystery "wafer" as you call it which is hilarious by the way, better be ready. I so appreciate the feedback.

MDCinSC's picture
MDCinSC
Posts: 574
Joined: Feb 2013

With you getting your biopsy; me meeting my urologist for the first time.  I'll be sending warm fuzzies your way (plus a prayer or two if you'd like it) while I'm in there with MY Doc!

Bon Chance!  Mike

LKidd
Posts: 37
Joined: Feb 2013

Yay, thanks MDC. Crossing fingers and ready to nix this thing. Good luck with your Urology appt.

garym's picture
garym
Posts: 1651
Joined: Nov 2009

You'll breeze right through it and I'm sure it will be a whole lot easier than your imagination makes it out to be.  Try and relax this weekend.

MDCinSC's picture
MDCinSC
Posts: 574
Joined: Feb 2013

LOL Lets celebrate by meeting back here Monday night!  I'm pouring Single Malt.  Any takers?

 

Of course my appointment notification just arrived.  What I thought was a Urology Appointment turned out instead to ne an "ONCOLOGY" Appointment.  Wow, the power of one little word!

 

Still, the single malt is on me Monday night!  Bring your favorite scotch glass!  I can take whatever they dish out! LOL

"Once more unto the breach, dear friends, once more;
Or close the wall up with our English dead.
In peace there's nothing so becomes a man
As modest stillness and humility:
But when the blast of war blows in our ears,
Then imitate the action of the tiger;
Stiffen the sinews, summon up the blood,
Disguise fair nature with hard-favour'd rage;
Then lend the eye a terrible aspect;
Let pry through the portage of the head
Like the brass cannon; let the brow o'erwhelm it
As fearfully as doth a galled rock
O'erhang and jutty his confounded base,
Swill'd with the wild and wasteful ocean."

(William Shakespeare; Henry V Act III)

LKidd
Posts: 37
Joined: Feb 2013

Update:

Procedure yesterday went fine as far as I know. I did have a lot of questions for the Radiologist up front, written down. He also concurred with the Doc and says by the looks of it they all believe it's benign and an Angiomyolipoma. I really really really hope they are right. He also said due to the size, location and flatness of it, the biopsy would be more difficult and I might be in more pain after.

He was right. It was tough. Awake the whole time, following instruct. They tried to go in horizontally so they took only samples of the mass and not my kidney, although he told me he might take part of the kidney anyway cuz' the tumor is so thin and the needle so long that it might be unavoidable. Because of how small, they ended up taking 8 samples, 4 with a fine needle, 4 with a core biopsy needle that takes larger pieces. They went through my 11th and 12th ribs to get there. They had some trouble getting a clear pic of the dang thing in the beginning, but finally with some special guide light they brought in, got it. The 2 pathologists, anesthesia gal, the Radiologist, Ultrasound gal and the head Radiologist of the clinic were all there for this. Apparently this little friend of mine is challenging.

Went home in a lot of pain, painful all last night and couldn't get around much. My husband and friend were there and helped a lot. Today is much better. I can get around a lot better. The main pain like last night is gone, but it feels like a bunch of people stood in line and took shots at my kidney. Like punches. So doing much better, but getting around slowly. Slept sitting up, so kind of tired. Other than that I am doing well today.

I will find out the results this week. I will let you all know. Whew, glad that is done.

LKidd
Posts: 37
Joined: Feb 2013

Hi all - Well the mystery is over. The results from my biopsy on Monday 3/4 are in, I received them Thursday 3/7. My biopsy was done at the Huntsman Cancer Institute. They have their own pathology lab so the turn around is very very quick. My two month + journey and mystery about my tumor is over. It is a benign Angiomyolipoma. A fatty smooth cell tumor, it generally poses no complications and you just live with it. Or it growns extremely slowly and still poses no risks or complications. If it grows to a size of 6cm-8cm it can become dangerous as it can bleed/hemorrhage or rupture. So now I need to do a repeat follow up scan in one year to establish the growth rate. Once established, we will determine how often I need to scan the tumor to monitor it and make sure it does not grow too large. If it ever gets to 6cm-8cm, I will need to have the tumor removed.

I am elated and feel very lucky. I joined this site and am grateful to have received a lot of help, information, support and shared experiences. I was extremely scared, surprised by the tumor finding, and didn't know what to do or what to expect at all. My tumor ended up being unique and was not recognized by any Urologists which scared me more. It became a mystery. I went through all the tests and procedures to find out, which took a little over 2 months. It seemed like forever! But aside the help, information and support, what helped me most and put me at ease was the ability to read and talk to people on here about similar experiences with what they were going through, tests etc. It helped me know what to expect and how to handle it. It also took a lot out of the "What's going to happen" out of it. I am completely grateful for all of that, and all of the people on here who contribute. I also feel lucky and happy about the outcome of course, but also sad and somewhat guilty as I have been able to read stories on here that have had bad experiences, are going through terrible illness, or that are struggling with this awful disease. I just hope I can be as much help to others regardless of their status as everyone was to me, and maybe even shed some hope to someone in a similar situation. This site is invaluable.

Read full experience under LKidd

 

Texas_wedge's picture
Texas_wedge
Posts: 2807
Joined: Nov 2011

Great news!!  As you know, I believed that the mystery story would have a happy ending and that your wafer tumor would be unmasked and turn out not to be a villain after all.  

We all love the good news, especially when we've just had very sad news, like Karen's.

You've provided a good example of why we shouldn't panic the moment we get potentially bad tidings - often it turns out not to be as bad as we feared.

LKidd
Posts: 37
Joined: Feb 2013

You are right. It's hard not to panic, and i got two diagnosis and recommendations that were completely opposite. So it seemed to drag and likely was going to be one extreme or another. In the face of cancer, so much goes through your mind and you think of so many things. It was nice to have your insight and support. Specifically yours since you are so knowledgeable about this. It helped a lot. I am just healing from the biopsy which was a bear, they took 8 samples so getting back is taking longer. But I'll take that outcome any day, it was worth it in the end. Thanks again TW. You nailed my little friend!

garym's picture
garym
Posts: 1651
Joined: Nov 2009

LK,

We don't get near enough good news around here and even less fantastic news like yours, you must feel like you've won the lottery!

Congratulations,

Gary

LKidd
Posts: 37
Joined: Feb 2013

Thanks Gary. Indeed, a good way to put it, the lottery. I felt exactly like that. Thanks for the congrats, Like I said, still feel a little guilty. I thought my outcome was going to be different and I have read so many stories on here and learned so much. I feel great but feel sad that this kind of news couldn't happen more often to others. Thanks for your support.

Texas_wedge's picture
Texas_wedge
Posts: 2807
Joined: Nov 2011

We'll be sorry to see you go but we're all glad you don't belong here as of right, and hope you never do need to join us here on a more permanent basis.  

It was good to learn that your little friend wasn't a bad one after all. Go and celebrate life with a new insight and enjoy it thoroughly on behalf of those who aren't as lucky.

foxhd's picture
foxhd
Posts: 1897
Joined: Oct 2011

Wonderful news LKIDD! I am starting my day with a nice big smile! A victory for one is a victory for us all Now stay healthy!!!!!!!!!!

MDCinSC's picture
MDCinSC
Posts: 574
Joined: Feb 2013

I couldn't have said it any better myself!  I'm very pleased and excited for you Lkidd!

 

Mike

foxhd's picture
foxhd
Posts: 1897
Joined: Oct 2011

Wonderful news LKIDD! I am starting my day with a nice big smile! A victory for one is a victory for us all Now stay healthy!!!!!!!!!!

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