Minimally Complex Renal Cyst in rt Kidney

Jeff K

OK, I am a 41 yr old Male and have had a minimally complex (Bosniak IIF) cyst measuring 3.0 cm in my right kidney that was discovered in July 2003. Dr.'s have monitored it with Ultrasound and CT scans over the last 6 years, but this past year, it increased in size to 4.0 cm. Three urologists at Barnes-Jewish hospital in St. Louis have all said we should continue to watch it as the risk from surgery is actually greater than merely watching it via scans. The cyst shows a small hair-thin septation, but does not enhance and has no calcium or wall thickening at all.

Obviously, reading these stories of RCC and the various stages have scared me silly, so my inclination is to have the Dr. perform a robot assisted laprascopic partial nephrectomy and get this cyst (whether malignent or benign) out of there.

Can you all give me your advice as to what you would do if you were me?

Thanks so much for your responses.

wendyleigh

I think you need to have
I think you need to have confidence in your doctors. If you have an established urologist they have seen enough ultrasounds and CT scans to tell if it is cancerous. Have you seen more than one doctor? Can they take a biopsy of it? I had a radical nephrectomy on May 6th and it was not as easy recovering as I thought it would be. Mine was not robot assisted but I still would not recommend you to do it unless your doctors say you have to have it. I have several cyst in my breast that a different group of doctors have been watching for about 5 years. Now I am a little worried that it could be cancer and they were wrong all along. I have to have faith they know what they are doing. I pray that God will help you with your decision.

Jeff K

wendyleigh said:

I think you need to have
I think you need to have confidence in your doctors. If you have an established urologist they have seen enough ultrasounds and CT scans to tell if it is cancerous. Have you seen more than one doctor? Can they take a biopsy of it? I had a radical nephrectomy on May 6th and it was not as easy recovering as I thought it would be. Mine was not robot assisted but I still would not recommend you to do it unless your doctors say you have to have it. I have several cyst in my breast that a different group of doctors have been watching for about 5 years. Now I am a little worried that it could be cancer and they were wrong all along. I have to have faith they know what they are doing. I pray that God will help you with your decision.

Thanks for your feedback - just what I was looking for
I have seen 3 separate urologists within the hospital over the last 6 years. Two new ones just recently after the cyst had grown more than I was prepared for. However, in speaking with them, they continue to say they believe it looks benign and that cysts in the kidneys are very common. They also tell me that since kidney cancer is a slow growing cancer, if the cyst changes during my next ultrasound (1 year from now), they can always perform the surgery at that time and the risk that something would have spread is very low.

It is really not recommended to take a needle biopsy of kidney cysts as the risk of "seeding" the cancer (if it is there in the first place) is too high. They typically can't tell with 100% certainty unless they take the whole cyst out and test it.

Sounds like you are in the same boat as me with your cysts. It seems to always be in the back of my mind that I could have cancer that I could "get rid of" with an operation now. However, the surgical risk is one that I don't want to over look either (especially if it turned out benign and I went ahead with a partial nephrectormy that I didn't need).

Any other thoughts on this decision would be appreciated.

donna_lee

Jeff K said:

Thanks for your feedback - just what I was looking for
I have seen 3 separate urologists within the hospital over the last 6 years. Two new ones just recently after the cyst had grown more than I was prepared for. However, in speaking with them, they continue to say they believe it looks benign and that cysts in the kidneys are very common. They also tell me that since kidney cancer is a slow growing cancer, if the cyst changes during my next ultrasound (1 year from now), they can always perform the surgery at that time and the risk that something would have spread is very low.

It is really not recommended to take a needle biopsy of kidney cysts as the risk of "seeding" the cancer (if it is there in the first place) is too high. They typically can't tell with 100% certainty unless they take the whole cyst out and test it.

Sounds like you are in the same boat as me with your cysts. It seems to always be in the back of my mind that I could have cancer that I could "get rid of" with an operation now. However, the surgical risk is one that I don't want to over look either (especially if it turned out benign and I went ahead with a partial nephrectormy that I didn't need).

Any other thoughts on this decision would be appreciated.

Cysts, too
I had right radical nephrectomy in 2006. All subsequent CT scans show cysts in the other kidney plus liver. I just take it as good news that the radiologist calls it a cyst and not a growth/mass. Since 2006, I had two subsequesnt surgeries a year apart for lymph nodes -both cancerous that were not there one time, and had grown by the next CT. This summer is the first year in 4 that I can plan for something besides surgery and recovery and I'm taking full advantage of my "free" time.
Donna

Unknown

This comment has been removed by the Moderator

Mick70

Every diagnosis except stones

Hi, I'm really confused and thinking someone on this site may have experienced something similar and or have some suggestions. About a year ago I went to the doctor because I thought I had yet another UTI turned kidney infection. I was having right flank pain but not any of the other symptoms of a UTI (of which I've had many). She put me on antibiotics, just in case, and ordered some routine blood work. The blood work came back with elevated liver enzymes so she sent me for an ultrasound of my liver and the ultrasound tech noted a 2.3cm mass on my right kidney. I was then sent for an MRI (and subsequently a CAT scan). The scans noted that I had cortical scarring and lobulation of both kidneys but no mass. Obviously very relieved I reutrned to my normal pre-cancer scare life and seemed to be doing okay despite continued dull pain in my right flank. After about six months I finally returned to my doctor for a routine med update and mentioned that I continued to have the right flank pain. I questioned if there could be something else causing it. The pain is not as bad as I would imagine kidney stones to be but it, just as many have described on here, a dull pain, almost a burning in my ride side sometimes stretching into my front and or back rib area. This pain keeps me sitting very upright as any kind of slumping causes definite discomfort. The doc sent me to another ultrasound which noted specifically no renal scarring but mild renal pelviectasis in the right kidney. The doctor advised that it could be some kind of blockage or an infection and, once again, put me on antibiotics and did some blood work. The blood work came back with some issues of elevated renan acitivity levels and a low aldosterone ratio which she said could indicate some renal insufficiency. She then recommended that I see a nephrologist. I recently went to the nephrologist who referred me for a doppler ultrasound which came back showing a simple cyst in my right kidney. He assured me that the pain in my flank is not related to the cyst as it is so small it would be asymptomatic. So at this point, after a year of so many different diagnosis, I no longer know what to believe. I continue to have discomfort in my side and, everytime I ask what else it might be, I am sent for more testing for my kidneys and then sent home. In looking online I have found plenty of people who's mass was missed on an ulatrasound but found on an MRI/CAT but none, so far, who's mass was found on an ultrasound and missed on an MRI/CAT. I feel fairly confident that a mass would have been discovered by this time but do have some minor fears that this cyst they are now seeing could be the mass they saw a year ago in a different form. Has anyone ever experienced any thing similar or have any suggestions on what it might be? Just a side not, my liver enzyemes continue to rise despite the fact that I don't drink and am not signficantly overweight so I am also being sent to a hepatologist. 

icemantoo

The CT is the Gold Standard

Nick.

 

As far as the CT it is the Gold Standard as  far as whether it is a mass or not. Probablly not based upon your findings so far, but get an opinion from a urologist who specializes in Kidney Cancer. Meanwhile try and start a new forum post.

 

Icemantoo