Cyst or Cancer

mugabi

Dad dying of Stage IV Renal Cancer.  During MY vist to ER today for Kidney Stone they told me a cyst I had 5 years earlier doubled in size from 0.6 cm to 1.3 cm.

Not sure if this is a simple cyst or the complex type the report did not say. Anyone else see this before? 

 

Texas_wedge

Guessing

With progression that slow it strikes me as unlikely it's cancerous.  I expect you've been advised that watch and wait is the best approach.   Are you going to have regular checkups (scans) from now on to see whether it keeps growing? With your Dad having RCC, you will have access to expert advice on how to proceed.

mugabi

Texas_wedge said:

Guessing

With progression that slow it strikes me as unlikely it's cancerous.  I expect you've been advised that watch and wait is the best approach.   Are you going to have regular checkups (scans) from now on to see whether it keeps growing? With your Dad having RCC, you will have access to expert advice on how to proceed.

ER has no clue

They did CT Scan for kidney stone and reports that the cyst doubled in size and that I need to see a urologist.  They note nothing on if its complex or simple.  Said not to worry but the CT report says something different. 

Digger95

mugabi said:

ER has no clue

They did CT Scan for kidney stone and reports that the cyst doubled in size and that I need to see a urologist.  They note nothing on if its complex or simple.  Said not to worry but the CT report says something different. 

kidney cyst

Stay on top of it with annual exams but don't freak out.  I've had RCC myself and later they found a 2.0 cm cyst on my other kidney but apparently these are quite common.  It grew to 2.0 cm over several years but since then hasn't grown at all, so they feel that it is a benign growth.  I know how how frustrating these types of things can be, because you aways suspect the worst, but chances are that it really is a benign growth.

todd121

Cyst

When they found my tumor in my right kidney, they noted a very small growth in my left kidney (I think it was 0.6 cm). The urologist said that it's most likely a cyst. He said that people my age and older very often have them. I'm 51. The CT with contrast confirmed it as probably a cyst. It was fluid-filled.

Todd

mugabi

Update

Urologist was concerned by growth rate.  Told me to do CT with/without contrast.  Not able to do inside three days so he flipped to MRI.

Guess I am concerned by the reaction of the urologist. I thought cysts were no big deal and could grow. 

My question Is a MRI just as good as a CT scan for Kidney?

Digger95

mugabi said:

Update

Urologist was concerned by growth rate.  Told me to do CT with/without contrast.  Not able to do inside three days so he flipped to MRI.

Guess I am concerned by the reaction of the urologist. I thought cysts were no big deal and could grow. 

My question Is a MRI just as good as a CT scan for Kidney?

CT Scan vs. MRI

I've had both exams over the past twelve years as my insurance plans changed (one plan covered MRI and another would only pay for a CT).  Interestingly, one doctor told me that a CT scan, with and without contrast, is more diagnostic than MRI, but I do not know his reasoning behind that.  Perhaps someone with more knowledge will chime in and explain this a bit better.  As for growth rate, my kidney cyst doubled in size for two years consecutively... starting out at .5 cm, doubling to 1.0 cm the following year, and then it doubled again to 2.0 cm the year after that.  It has now been stable for several years and neither my doctor or I are concerned about it.  Your growth appears to be even slower and smaller, but of course do still stay on top of it with annual exams.

MedScanMan

mugabi said:

Update

Urologist was concerned by growth rate.  Told me to do CT with/without contrast.  Not able to do inside three days so he flipped to MRI.

Guess I am concerned by the reaction of the urologist. I thought cysts were no big deal and could grow. 

My question Is a MRI just as good as a CT scan for Kidney?

MRI vs CT

The MRI will surely tell your doctor if this is in fact a cyst.  When you were in the ER, you had your CT scan without contrast because they were looking for a kidney stone and in this case the contrast would have actually gotten in the way.  Following the ureters down to the UV junction where a lot of painful kidney stones are seen, having the ureters lit up with contrast might over shadow a small stone.  The calcification shows much better with no contrast.  As far as your cyst and in answer to another post, I would prefer a CT scan with and without contrast.  You'll have a much better and clearer look at the cyst, the measurements (not size) but in Hounsfield units will make absolutely sure that it is a cyst and most important there will be a chance to measure the delayed contrast images to absolutely verify renal cell vs. cyst.  Today's CT with 3D reconstruction in my opinion give a much better look at both the Kidneys and just as important the enhanced pelvis to search for any pelvic adenopathy.  MRI for me at least has always been a great way to confirm something on the CT scan if there is a question.  Hundreds of times over the years I've been asked by patients (no matter what the body part in question is) "What's better a Cat Scan or an MRI?)".  The only true answer is each has its place.  Name the body part and the answer is easy.

 

Jeff

 

mugabi

MedScanMan said:

MRI vs CT

The MRI will surely tell your doctor if this is in fact a cyst.  When you were in the ER, you had your CT scan without contrast because they were looking for a kidney stone and in this case the contrast would have actually gotten in the way.  Following the ureters down to the UV junction where a lot of painful kidney stones are seen, having the ureters lit up with contrast might over shadow a small stone.  The calcification shows much better with no contrast.  As far as your cyst and in answer to another post, I would prefer a CT scan with and without contrast.  You'll have a much better and clearer look at the cyst, the measurements (not size) but in Hounsfield units will make absolutely sure that it is a cyst and most important there will be a chance to measure the delayed contrast images to absolutely verify renal cell vs. cyst.  Today's CT with 3D reconstruction in my opinion give a much better look at both the Kidneys and just as important the enhanced pelvis to search for any pelvic adenopathy.  MRI for me at least has always been a great way to confirm something on the CT scan if there is a question.  Hundreds of times over the years I've been asked by patients (no matter what the body part in question is) "What's better a Cat Scan or an MRI?)".  The only true answer is each has its place.  Name the body part and the answer is easy.

 

Jeff

 

Great Answer

Jeff,

Wow- great answer.  Thanks.  So the story gets a bit strange.  First- as noted above- the Urologist was concerned that it grew from 0.6 CM (Jan 2007) to 1.3 CM (last week) and ordered the MRI.  Checking my paperwork- the January 2007 Radiologist report from the CT scan mentions no word of the 0.6 CM cyst.  And I would have remembered due to my dad.  I got my MRI results in the past hour from yesterday- indeed a simple cyst- measures 1.7 CM.

So three questions if you dont mind:

1) Why would the radiologist report not show the 0.6 CM results in the write-up?  Clearly- last week (on Stone Scan) they referenced to 2007 CT result.

2) My Cyst grew from 1.3 CM to 1.7 CM in 6 days?  Now that is growing!  Is an MRI more sturdy/reliable for size than the scan I got from the Emergency room (last week) looking for kindey stones?

 3) You menioned above that an MRI will tell you if its a cyst. but note that you prefer a CT scan/ with and withou contrast.  You note that the look is clearer but that you are really sure its a cyst.  Did I waste time with the MRI- especially if point #2 is accurate?  Could this be RCC? 

Thanks Jeff. 

MedScanMan

mugabi said:

Great Answer

Jeff,

Wow- great answer.  Thanks.  So the story gets a bit strange.  First- as noted above- the Urologist was concerned that it grew from 0.6 CM (Jan 2007) to 1.3 CM (last week) and ordered the MRI.  Checking my paperwork- the January 2007 Radiologist report from the CT scan mentions no word of the 0.6 CM cyst.  And I would have remembered due to my dad.  I got my MRI results in the past hour from yesterday- indeed a simple cyst- measures 1.7 CM.

So three questions if you dont mind:

1) Why would the radiologist report not show the 0.6 CM results in the write-up?  Clearly- last week (on Stone Scan) they referenced to 2007 CT result.

2) My Cyst grew from 1.3 CM to 1.7 CM in 6 days?  Now that is growing!  Is an MRI more sturdy/reliable for size than the scan I got from the Emergency room (last week) looking for kindey stones?

 3) You menioned above that an MRI will tell you if its a cyst. but note that you prefer a CT scan/ with and withou contrast.  You note that the look is clearer but that you are really sure its a cyst.  Did I waste time with the MRI- especially if point #2 is accurate?  Could this be RCC? 

Thanks Jeff. 

Radiologists are people too/Sometimes

I'm guessing that the radiologist felt that a 6mm cyst was not worth his while, or he in fact missed it.  That small, the technologist may not have even measured it.  I would have.  Your cyst didn't grow from 1.3 to 1.7cm in 6 days.  The technologist just measured it on a different axial image.  It depends where he or she puts the lines to make the measurement as well as whether the image was taken with a breath in or a breath out....the difference here is insignificant.  If they called it cyst on your new MRI then that's what it is.  Just a little overkill, that's all.  The point is.............you're fine.

Jeff