Very long but need any advice on 6 month CT scan

 

So I have been following and posting here randomly . I dont always know what to say but try to help. You all have been a great help to me. I am here agian for any advice and prayers. I just had my six month scan results today and I am really trouble and scared. Here is my history again. Stage 1 Grade 1  4.5cm. No Rhabdoid or Sarcmotoid features. Limited to the Kidney. No lymph nodes involved. Margins: uninvolved my carcinoma. I first DX because I was having stomach pain, which lead to Ct that found the mass on kidney. I was always told the stomach knot I felt is a hernia or scar tissue from other hysterectomy. I had an robotic partial that went well. Then day 2 in hospital the nurses tried to move me and I fell and ended up bleeding from my kidney so took the whole kidney. I had a real hard recovery. Here is a history of what my scan show. They last being the most recent. My oncologist stated she is confused and not in total agreement with my last  CT report.  Alot of my report state from last or previous. When its never  been mentioned on any report. She wants me to have a biopsy. Any advice will be grealty appreciated. 

 

10/19/2017 prior to surgery

 4.4 x 4.2 x 4.6 cm heterogeneous enhancing left renal mass with stable appearance since prior examination.
2. Mildly enlarged left periaortic lymph nodes, measuring up to 12 mm in short axis.
3. Prominent spleen, measuring 13 cm in craniocaudal dimension.
4. Small fat-containing umbilical hernia.
5. Moderate to large volume of stool seen throughout the colon.
6. 2.5 cm right adnexal low density, which may represent right ovarian etiology. If clinically indicated, pelvic ultrasound can be obtained for better evaluation  I had ob ultra sound and was told cyst was gone.

 

12/28/17 First Ct after to surgery

Post left nephrectomy with no residual or recurrent mass lesion identified. No CT evidence of metastatic disease within the abdomen/pelvis.
2. Cystic lesion in the right adnexa measuring maximally 2.2 cm and unchanged from 10/19/2017
3. Mild hepatosplenomegaly which appears unchanged.
4. Please see above for complete discussion.

subcentimeter hypodense lesion in the superior pole the right kidney measures maximally 7 mm and appears unchanged. This is difficult to characterize due to its small size but likely reflects a small cyst. The right kidney and ureter appear normal otherwise. Patient is post left nephrectomy. No mass lesion identified in the left renal fossa. Retroperitoneal hemorrhage seen previously appears completely resolved.

 

5/22/2018 6month scan

CT CHEST:
1. No evidence for metastatic disease in the chest

CT ABDOMEN AND PELVIS:
1. Surgical changes of prior left nephrectomy
2. Enhancing nodular density identified in the right lower quadrant anterior abdominal wall, best seen on image #65 series #3, that may be metastatic in origin given the interval increase in size and the enhancing nature of this finding.
3. Suspected enhancing nodule identified in the right rectus abdominis musculature, also likely metastatic in nature
4. Splenomegaly

 

Gallbladder: The gallbladder is distended with a smooth thin wall.
Biliary tree: There is no evidence for intra-or extrahepatic biliary ductal dilatation.
Liver: The liver demonstrates normal appearance. No focal abnormalities are seen. Normal contrast enhancement is noted.
Spleen: The spleen is enlarged measuring 14.4 cm in length.
Pancreas: Normal morphology without masses or inflammatory changes.
Adrenals: Normal size without masses.
Kidneys: The right kidney is unremarkable. The left kidney is surgically absent. There is no evidence for enhancing soft tissue density in the left renal fossa.
Vasculature: No evidence of aneurysm or other significant vascular pathology. No evidence of dissection.
Lymphatic system: No pathologically enlarged lymph nodes are seen.
Bowel: The stomach is normally distended with no focal wall abnormality. The duodenum is normal in caliber along its course. No focal abnormality is seen. The small bowel is normal caliber. There is no focal stricture or dilatation. There is moderate colonic fecal stasis. The appendix is not seen.
Peritoneal structures: No evidence of free air or free fluid. No masses. The omentum and small bowel mesentery are normal.
Retroperitoneum: No focal retroperitoneal abnormality is seen.

Abdominal wall: Small fat-containing umbilical hernia is noted. There is a suspected enhancing soft tissue density identified in the right lower quadrant abdominal wall as seen on image #65 series #3 that measures 34 x 21 mm (previous 24 x 15 mm). There is an additional nodule identified in the right rectus abdominis muscle as seen on image #52 series #3 measuring 20 x 18 mm (previous 19 x 17 mm).

CT PELVIS:
Urinary bladder: The urinary bladder is distended with a smooth thin wall. No focal abnormalities are seen. No posterior filling defects are seen on delayed phase imaging.
Soft tissues: No other significant abnormalities in the pelvic structures. No free fluid or lymphadenopathy. The ischiorectal fossa and inguinal regions are normal.
Bones: No significant abnormalities in the bony pelvis.