Adrenal nodule and CT without contrast...

Digger95

Hi all and thanks in advance for any insight you can provide,

I am twelve years post RCC and right radical nephrectomy.  My doctor stopped ordering contrast for my annual follow-ups some years ago but in the meantime a 2.0 cm growth appeared on my left adrenal gland.  This didn't really worry me until I read some recent posts about the necessity of getting contrast studies done.  As I am currently out of work and without health insurance I will be unable to schedule a follow-up exam anytime soon so I'm a bit worried.  How accurate are CT scans without contrast?  

My 2012 report states:

"There is a left adrenal adenoma which shows signal drop off on the out of phase imaging indicating the presence of adenoma rather than neoplasm and has a maximum diameter of 2 cm and has not changed significantly in appearance or size since the previous CT scan."

In fact it has not changed in size in over four years now but again these were all non-contrast CT scans.

Just wondering how concerned I should be about this?

Jim

 

MedScanMan

I think you're OK here

Jim,

If the adrenal adenoma has not changed in size in a four year period, and out of phase imaging makes the radiologist comfortable enough to not make comments in the impression giving all sorts of testing to do to make sure that he covers his butt.....I think it is what it is.  An ultrasound would be much less expensive since you would be a cash pay, and you could probably have a renal ultrasound to include adrenals at a small out patient center for a few hundred dollars.  They love off the street cash pay customers with a doctors prescription in hand.  Only in America.

Good luck

Jeff

Digger95

MedScanMan said:

I think you're OK here

Jim,

If the adrenal adenoma has not changed in size in a four year period, and out of phase imaging makes the radiologist comfortable enough to not make comments in the impression giving all sorts of testing to do to make sure that he covers his butt.....I think it is what it is.  An ultrasound would be much less expensive since you would be a cash pay, and you could probably have a renal ultrasound to include adrenals at a small out patient center for a few hundred dollars.  They love off the street cash pay customers with a doctors prescription in hand.  Only in America.

Good luck

Jeff

Thanks!

Jeff, I greatly appreciate your input.  

I'm not even due for my regular annual follow-up again until August, and my previous ones have all been fine, so I probably shouldn't even be worrying about this yet.  By August I may very well be gainfully employed again and not have missed a single check-up.  I guess just being without insurance gets one to thinking all sorts of terrible things that aren't really even a 'thing' at all.   

The radiologist did note on my last report that:

"The study was requested without IV contrast which limits the examination for detection of early metastatic disease."

However the signal drop-off and absence of change in appearance or size over an extended period of time seems to have set his (and my) mind at ease.

Thanks again,

Jim