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Question about CT scan report

jojeti
Posts: 2
Joined: Jul 2013

My husband had what we thought were benign tumors in his right kidney for which he would get a CT scan each year to see if they grew.  They were first noticed about 2 1/2 years ago during doctoring for a kidney stone that had to be surgically removed.  Well, this year they grew.  His CT scan was 6/28 and he got a call from his urologist on 7/3 and was told he needs to have the right kidney removed and his surgery date is tomorrow.  A couple of days ago he had his preop physical, bloodwork and a CT scan of his lungs.  We have not heard results from those tests yet.  Anyway, from his CT scan report dated 6/28, it says: "large right renal solid mass measuring approximately 4.1x4.4x2.9 cm increased from previous examination (6/12) 3.5x4.0x2.7cm  The exophytic inferior right renal pole cyst is unchanged....".  Under the catagory of spleen, it says "spleen is enlarge measuring 14 cm in AP".  Under other it says, "limited evaluation of chest demonstrates a noncalcified pulmonary nodule measuring 0.5 cm in the right lower lobe, not previously imaged."  Under Conclusion, "1.  Right renal mass is increased in size.  Whether this represents renal cell carcinoma or oncocytoma is uncertain. 2.  Indeterminate noncalcified right lower lobe pulmonary nodule"

My questions...

I know one can have spots on their lungs and enlarged spleen for other reasons, but is an enlarged spleen something that is seen with RCC?

Any other thoughts?

icemantoo's picture
icemantoo
Posts: 1479
Joined: Jan 2010

Many cysts are benign. However their chance of being malignant increses as they grow. I believe the size is beyond the watch and wait. The good news is that even if it is malignant it is small enough that surgery should be a total cure. I have no input with regard to the enlarged spleen. The other concern is that at 4.4 cm even if it is not malignatnt it may very well become malignant.

As for the lung nodule this must be watched as it is where RCC can spread. These are usually measured in mm and they become a concern if they are more than .8 mm . It may be that the lung nodule is .5mm rather than .5cm. I hope so.

 

 

Icemantoo

jojeti
Posts: 2
Joined: Jul 2013

Thank you for your response.  The tumor in the kidney, the one that has grown is not a cyst but the other one in his kidney is a cyst.  I think the concerning factor was how fast it has grown.  The lung nodule was definitely 0.5 cm not mm.  Getting ready to take him to the hospital...I will be glad when the kidney is out. 

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

Jojeti.

First, welcome to the club nobody wants to join and I'm sorry you are here.  That said this is a very supportive group and we'll help any way we can.

Just to clarify; 0.5cm = 5.0mm or 0.19 inches, still very small...0.8mm = 0.03 inches (smaller than a pin head) and not likely measurable...8.0mm = 0.31 inches (about the size of a pea), you aren't there yet.  The kidney mass is roughly golf ball size and still considered small in terms of RCC and it is extremely unlikely that it has spread at this size.  I can't offer an opinion on the spleen, but I would be surprised if it was related to the kidney.

Good luck and Godspeed,

Gary

GSRon's picture
GSRon
Posts: 1182
Joined: Jan 2013

OK, not sure this is the same or not.. but my spleen (and Liver) were enlarged before surgery.  It took about a year for both to end up within normal size.  My Doctors did not know why.. nor were they really concerned.  Keep in mind that nasty foreign object has upset the proverbial apple cart.   I suggest you look at the blood tests to see if there is anything abnormal.  Ask your Doctor too..  Hopefully all will be fine after the surgery...

Good Luck.!

Ron

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

We all share your view that it will be good to have the op and I wish you luck that all goes well. 

In deference to the Grand Old Man of this board, Gary elucidated the figures but didn't point out that iceman got the decimal point in the wrong place at one point.  Everything iceman said is correct (and certainly his conclusions) if we take him to have meant to say .8 cm, rather than .8 mm.  So, as you say, the lung nodule was .5 cm and this fits into iceman's figure of .8 cm (8 mm) as the cut-off point, below which you shouldn't be worried, so far, at least, but need to keep an eye on it.  As iceman said, lungs are a likely destination for RCC mets, hence the need to keep an eye on that nodule.

You asked a very sensible question about spleen enlargement and both iceman and Gary, understandably, had no substantial answer to offer.  We do know that the spleen can be affected by RCC but that it's a long way down in the likely first destinations.  Also, as you  rightly say, there are multiple other causes for spleen enlargement, some of which give no cause for concern.  It will be worth monitoring it after the nephrectomy.  A handy article on causes of spleen enlargement, which you may have already seen, is on WebMD at: 

http://www.webmd.com/digestive-disorders/enlarged-spleen-causes-symptoms-and-treatments

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