got mri report any help would be appreciated

daisybud
daisybud Member Posts: 541 Member

I had US last week said everything was fine. I had urq pain.  Then dr had me do ct this is what it said...

CT----heterogeneous enhanced lesion on right kidney 2.0x1.8 in midpole right kidney

Impression  1.  Indeterminate 2.0x1.8 cm lesion in the right kidney,.  This could represent renal cell carinonma.  Further evaluation is recommened.  If indicated, an MRI cold be preformed to futher chacterize this.

So I had MRI yesterday.

Today got MRI report...

MRI---Inhomegeneously enhancing noncystic mass at the upper pole of the right kidney measuring 2.5x2.1x2.3cm Thios lesion has an enhancing capsule or pseudecapsule.  This in not the characteristic apearance for simple cyst or renal cell malignancy.  It may represent a complxs cyst.  It may represent a complex cystic malignancy.

Impression:  1.   2.5x2.1x2.3 cm complex cyst or complex cystic involing the right upper pole malignancy with possible early renal pelvis invitation

                   2.  no vascular incvasion, lymphadenopathy or liver metastases

 

I know that a ct is the gold standard but these seem so different to me.

Anyone willing to chime in on what they think of these results

KIm

Comments

  • icemantoo
    icemantoo Member Posts: 3,361 Member
    Complex cyst

    Daisy,

     

    Simple cysts are unlikely to turn into RCC while a complex cyst may turn malignant as it grows if it grows. What exacty yours is, is above my paygrade. There may not be a yes or no answer to whether yours is malignant. See what your doctor says and seek a second opinion if you are not 100% sure and confidant in his approach.

     

     

    Icemantoo

  • medic1971
    medic1971 Member Posts: 225 Member
    My 2 pennies...

    You have two different diagnostic images possibly read by two separate radiologists.  Were your films ready by different radiologists?  I've learned that you can have two radiologists look at the same film and get different results, so just keep that in mind.

    The size difference between the two studies maybe due how thin the slices were during the scan.  This is not uncommon.  I suspect that the MRI measurements are more accurate.  They will know for sure when and if they do pathology.

    I think it's your chances for this not being cancer have gone up slightly, but I think your chances of having a partial nephrectomy have gone down due to it's location nearing the renal pelvis.  

    If I were in your shoes I would find the nearest major cancer hospital and get a second opinion.  I would hate for you to lose an entire kidney just to find out that this is a complex cyst.

     

    Good luck and keep us posted.  

     

    Jason 

  • donna_lee
    donna_lee Member Posts: 1,041 Member
    medic1971 said:

    My 2 pennies...

    You have two different diagnostic images possibly read by two separate radiologists.  Were your films ready by different radiologists?  I've learned that you can have two radiologists look at the same film and get different results, so just keep that in mind.

    The size difference between the two studies maybe due how thin the slices were during the scan.  This is not uncommon.  I suspect that the MRI measurements are more accurate.  They will know for sure when and if they do pathology.

    I think it's your chances for this not being cancer have gone up slightly, but I think your chances of having a partial nephrectomy have gone down due to it's location nearing the renal pelvis.  

    If I were in your shoes I would find the nearest major cancer hospital and get a second opinion.  I would hate for you to lose an entire kidney just to find out that this is a complex cyst.

     

    Good luck and keep us posted.  

     

    Jason 

    Well, Holy Moly...

    I agree with Jason about the 2nd opinion.  But the reverse side of his other comment is that if you ignore it and it is a cyst that could turn malignant, you certainly don't wand it hanging around in there.  The encapsulated part sounds great.  The size of the "??" is even better.

    If you can find a surgical oncologist who specializes in kidney cancers, it would be great.  They have more experience looking at test results-US, CT, MRI- and what they turn out to be upon removal and biopsy, than the average surgeon.

    And, as you and others before you have found, once you start having all those black and white or colored pictures to look at, there will be cysts and odd spots in lots of organs.  Those will be watched for a few more tests and then determined to be benign.  I have them in the remaining kidney, the pancreas, and what is left of my liver.

    Guess you received a few answers to encourage you to seek and find an answer that is right for you.  You go, girl.

    Hugs, Donna

  • daisybud
    daisybud Member Posts: 541 Member
    donna_lee said:

    Well, Holy Moly...

    I agree with Jason about the 2nd opinion.  But the reverse side of his other comment is that if you ignore it and it is a cyst that could turn malignant, you certainly don't wand it hanging around in there.  The encapsulated part sounds great.  The size of the "??" is even better.

    If you can find a surgical oncologist who specializes in kidney cancers, it would be great.  They have more experience looking at test results-US, CT, MRI- and what they turn out to be upon removal and biopsy, than the average surgeon.

    And, as you and others before you have found, once you start having all those black and white or colored pictures to look at, there will be cysts and odd spots in lots of organs.  Those will be watched for a few more tests and then determined to be benign.  I have them in the remaining kidney, the pancreas, and what is left of my liver.

    Guess you received a few answers to encourage you to seek and find an answer that is right for you.  You go, girl.

    Hugs, Donna

    I am going this Tuesday to

    I am going this Tuesday to the urologist.  I will def keep that appt.  He is a urologist but I do know he is works out of the local hospital that is partnered with Fox Chase.  They have a Fox Chase Cancer outpatient center here. I did ask the lady who answered the phone when I called his office if he took care of kidney cancer patients or if I should find someone else.  She said he did.  We shall see... After the Tuesday appt I will be armed with more answers and probably more question too.. At least I sure as H*ll hope so..   Then I will have to decide who to see for a second opinion..  Thanks for all the info and feed back..  Again you guys are great! Love to all of you :)

    Kim

  • foxhd
    foxhd Member Posts: 3,181 Member
    daisybud said:

    I am going this Tuesday to

    I am going this Tuesday to the urologist.  I will def keep that appt.  He is a urologist but I do know he is works out of the local hospital that is partnered with Fox Chase.  They have a Fox Chase Cancer outpatient center here. I did ask the lady who answered the phone when I called his office if he took care of kidney cancer patients or if I should find someone else.  She said he did.  We shall see... After the Tuesday appt I will be armed with more answers and probably more question too.. At least I sure as H*ll hope so..   Then I will have to decide who to see for a second opinion..  Thanks for all the info and feed back..  Again you guys are great! Love to all of you :)

    Kim

    My opinion

    The smart choice is to remove the lesions. Even if you have to lose a kidney. But not necessarily now. Get scans every couple or 3months. If there are negative changes, have it removed. If it remains the same, it may have been there for a long time. Many of us have cysts somewhere. The radiologists' always mention them. They get closely watched.

  • daisybud
    daisybud Member Posts: 541 Member
    foxhd said:

    My opinion

    The smart choice is to remove the lesions. Even if you have to lose a kidney. But not necessarily now. Get scans every couple or 3months. If there are negative changes, have it removed. If it remains the same, it may have been there for a long time. Many of us have cysts somewhere. The radiologists' always mention them. They get closely watched.

    Fox,
    The only reason I would

    Fox,

    The only reason I would want to do it now is because the MRI report said possible complex cystic malignancy. Just the mention of it makes me want to get it out now.  I know it was not there in 2011 bc I had a ct scan for possible gallbadder issue.  I have to just sit tight till dr appt next week. 

    By the way I live 45 min north of Phila.  I don't know where everyone else lives but if you live on the northeast stay safe and warm.  We are expected a blizzard like snow storm!

    Kim

  • hardo718
    hardo718 Member Posts: 853 Member
    daisybud said:

    Fox,
    The only reason I would

    Fox,

    The only reason I would want to do it now is because the MRI report said possible complex cystic malignancy. Just the mention of it makes me want to get it out now.  I know it was not there in 2011 bc I had a ct scan for possible gallbadder issue.  I have to just sit tight till dr appt next week. 

    By the way I live 45 min north of Phila.  I don't know where everyone else lives but if you live on the northeast stay safe and warm.  We are expected a blizzard like snow storm!

    Kim

    I'm with you Kim...

    ....if it were me I'd want it out too, given all the circumstances.  The size difference between CT, MRI, US doesn't mean much, we're talking millimeters in difference.  The things that are red flags to me is the mention of enhanced capsulation.  I also had mention of that on my reports and since I was working in a hospital at the time, showed this to doctors I worked side by side with, (none being uro-onc docs by the way) and they all said the same thing, get rid of it.  As did my uro-onc doctor when I saw him.  I was lucky, "Bob the Blob" was still encapsulated when I had my surgery but just barely I was told.

    Looking forward to hearing what your uro doc has to say, keep us posted.

    Praying for you,

    Donna~

  • daisybud said:

    I am going this Tuesday to

    I am going this Tuesday to the urologist.  I will def keep that appt.  He is a urologist but I do know he is works out of the local hospital that is partnered with Fox Chase.  They have a Fox Chase Cancer outpatient center here. I did ask the lady who answered the phone when I called his office if he took care of kidney cancer patients or if I should find someone else.  She said he did.  We shall see... After the Tuesday appt I will be armed with more answers and probably more question too.. At least I sure as H*ll hope so..   Then I will have to decide who to see for a second opinion..  Thanks for all the info and feed back..  Again you guys are great! Love to all of you :)

    Kim

    If you can get Dr. Robert

    If you can get Dr. Robert Uzzo at Fox Chase on your team, he has great reviews, and he was on the panel that wrote the guidlines for kidney masses for the American Urological Association:

    https://www.foxchase.org/robert-uzzo

    http://www.healthgrades.com/physician/dr-robert-uzzo-xftlc

    The Guidelines have a lot of great information:

    https://www.auanet.org/education/guidelines/renal-mass.cfm

    ----

    Dr. Uzzo was on my list, but I went with another doctor on that panel who works out of Sloan Kettering.

  • daisybud
    daisybud Member Posts: 541 Member

    If you can get Dr. Robert

    If you can get Dr. Robert Uzzo at Fox Chase on your team, he has great reviews, and he was on the panel that wrote the guidlines for kidney masses for the American Urological Association:

    https://www.foxchase.org/robert-uzzo

    http://www.healthgrades.com/physician/dr-robert-uzzo-xftlc

    The Guidelines have a lot of great information:

    https://www.auanet.org/education/guidelines/renal-mass.cfm

    ----

    Dr. Uzzo was on my list, but I went with another doctor on that panel who works out of Sloan Kettering.

    Positive,
    Thanks. I just

    Positive,

    Thanks. I just wrote that info down.  Appreciate the help.

    Kim

  • jason.2835
    jason.2835 Member Posts: 337 Member
    MRI

    Daisybud,

    My MRI report was much less positive.  It just said "Most likely cystic renal cell carcinoma."  So I will echo what others have said and remember that it is very much dependent upon the experience and thoughts of the human who is looking at your films.  Definitely have an oncologist that specializes in RCC look at your films at some point.  It sounds like what is going on in there is not totally cut and dry.  

    The good news is that it is very small and no matter what it is your prognosis is going to be excellent.  So remember to hang your hat on that.

    - Jay 

  • Pandabear1011
    Pandabear1011 Member Posts: 123 Member
    Kim...

    I had an MRI before my surgery and it measured my tumor larger thsn it actually was after my nephretomy. I was very happy about that! Sending good vibes your way for an informative doctor visit. Hopefully all your questions will be answered. Keep us posted. We are here for you...Panda

  • daisybud
    daisybud Member Posts: 541 Member

    Kim...

    I had an MRI before my surgery and it measured my tumor larger thsn it actually was after my nephretomy. I was very happy about that! Sending good vibes your way for an informative doctor visit. Hopefully all your questions will be answered. Keep us posted. We are here for you...Panda

    Thanks Panda
    I cant wait for

    Thanks Panda

    I cant wait for Tuesday to get here so I know more. We had a huge snow storm this weekend and all I can think about is they better clear the roads so I can get there!!! I will post after appt because I know I will need help digesting all the information I am sure I will get.  I have to stop looking at the test reports and looking stuff up on the internet.  I agree with the others the tests were read by two different radiologists so thats why the impressions are so different. 

    Kim 

     

  • todd121
    todd121 Member Posts: 1,448 Member
    Scans - Differences

    I don't think the scans are that much different. "Lesion" is a very vague term. The MRI says it's not typical of a "simple" cyst or "simple" rcc malignancy. RCC has several different types. I'm not sure what they mean by "simple" RCC. When I had my CT, my doctor, who specializes in kidney masses, said that from imaging alone it's not really possible to tell what most of these are. However, when it's large 90% of them are cancer. Yours is on the small size for an RCC tumor, but on the large size for a cyst. They probably are not going to know what it is until they can get it out and look at it under a microscope. Because these things are not uniform, they don't usually do biopsies to figure out what they are either (you only get to see where you sample, and you can't take enough samples to really get a thorough reading). These masses are often not uniform. You can even have different kinds of RCC in the same mass.

    The only thing that bugs me about these two reports is one says it's "midpole" and the other says it's upper pole. Perhaps the first meant mid, upper pole? You want it away from the center of the kidney, where all the blood supply flows in and out. You have a better chance of being able to do a partial that way.

    BTW, it says no vascular involvement on the scans, but I can tell you from experience they won't know that until they get it under a miscroscope either. I hope it's the case for you. The further from the blood supply, the more likely there is no vascular involvement, the better.

    You may end up having 2 options? Wait and watch to see if it grows. (If it was in the middle of the kidney near the blood supply, I wouldn't do that myself, but see what your doctors say). Take it out and find out what it is. Best would be if they can do a partial if they can get clear margins. I wouldn't want a partial unless clear margins were easy to get. My tumor was in the middle of my kidney, and for that reason I couldn't have a partial. It was too much in the middle of all the blood supply lines come in and out.

    My doctors did no MRI and no biopsies. However, my tumor was a lot larger than yours (around 5-7cm, I forget exactly). If they want to do biopsies, I'd ask to see what they hope to gain by it. A positive biopsy (say for RCC) would tell you something. However, a negative biopsy would add no information with regards to cancer.

    Please let us know how it goes. I'm sending you positive energy.

    Hugs,

    Todd

  • daisybud
    daisybud Member Posts: 541 Member
    todd121 said:

    Scans - Differences

    I don't think the scans are that much different. "Lesion" is a very vague term. The MRI says it's not typical of a "simple" cyst or "simple" rcc malignancy. RCC has several different types. I'm not sure what they mean by "simple" RCC. When I had my CT, my doctor, who specializes in kidney masses, said that from imaging alone it's not really possible to tell what most of these are. However, when it's large 90% of them are cancer. Yours is on the small size for an RCC tumor, but on the large size for a cyst. They probably are not going to know what it is until they can get it out and look at it under a microscope. Because these things are not uniform, they don't usually do biopsies to figure out what they are either (you only get to see where you sample, and you can't take enough samples to really get a thorough reading). These masses are often not uniform. You can even have different kinds of RCC in the same mass.

    The only thing that bugs me about these two reports is one says it's "midpole" and the other says it's upper pole. Perhaps the first meant mid, upper pole? You want it away from the center of the kidney, where all the blood supply flows in and out. You have a better chance of being able to do a partial that way.

    BTW, it says no vascular involvement on the scans, but I can tell you from experience they won't know that until they get it under a miscroscope either. I hope it's the case for you. The further from the blood supply, the more likely there is no vascular involvement, the better.

    You may end up having 2 options? Wait and watch to see if it grows. (If it was in the middle of the kidney near the blood supply, I wouldn't do that myself, but see what your doctors say). Take it out and find out what it is. Best would be if they can do a partial if they can get clear margins. I wouldn't want a partial unless clear margins were easy to get. My tumor was in the middle of my kidney, and for that reason I couldn't have a partial. It was too much in the middle of all the blood supply lines come in and out.

    My doctors did no MRI and no biopsies. However, my tumor was a lot larger than yours (around 5-7cm, I forget exactly). If they want to do biopsies, I'd ask to see what they hope to gain by it. A positive biopsy (say for RCC) would tell you something. However, a negative biopsy would add no information with regards to cancer.

    Please let us know how it goes. I'm sending you positive energy.

    Hugs,

    Todd

    Thanks Todd,
    I am going

    Thanks Todd,

    I am going tomorrow.  I will def ask about the location since it does say two different places for the location and how that would afffect the surgery. I did not know that it was on the large side for a cyst.  What is a large size for a cyst? Guess I will ask that tomorrow too. 

    Kim

  • daisybud
    daisybud Member Posts: 541 Member
    todd121 said:

    Scans - Differences

    I don't think the scans are that much different. "Lesion" is a very vague term. The MRI says it's not typical of a "simple" cyst or "simple" rcc malignancy. RCC has several different types. I'm not sure what they mean by "simple" RCC. When I had my CT, my doctor, who specializes in kidney masses, said that from imaging alone it's not really possible to tell what most of these are. However, when it's large 90% of them are cancer. Yours is on the small size for an RCC tumor, but on the large size for a cyst. They probably are not going to know what it is until they can get it out and look at it under a microscope. Because these things are not uniform, they don't usually do biopsies to figure out what they are either (you only get to see where you sample, and you can't take enough samples to really get a thorough reading). These masses are often not uniform. You can even have different kinds of RCC in the same mass.

    The only thing that bugs me about these two reports is one says it's "midpole" and the other says it's upper pole. Perhaps the first meant mid, upper pole? You want it away from the center of the kidney, where all the blood supply flows in and out. You have a better chance of being able to do a partial that way.

    BTW, it says no vascular involvement on the scans, but I can tell you from experience they won't know that until they get it under a miscroscope either. I hope it's the case for you. The further from the blood supply, the more likely there is no vascular involvement, the better.

    You may end up having 2 options? Wait and watch to see if it grows. (If it was in the middle of the kidney near the blood supply, I wouldn't do that myself, but see what your doctors say). Take it out and find out what it is. Best would be if they can do a partial if they can get clear margins. I wouldn't want a partial unless clear margins were easy to get. My tumor was in the middle of my kidney, and for that reason I couldn't have a partial. It was too much in the middle of all the blood supply lines come in and out.

    My doctors did no MRI and no biopsies. However, my tumor was a lot larger than yours (around 5-7cm, I forget exactly). If they want to do biopsies, I'd ask to see what they hope to gain by it. A positive biopsy (say for RCC) would tell you something. However, a negative biopsy would add no information with regards to cancer.

    Please let us know how it goes. I'm sending you positive energy.

    Hugs,

    Todd

    Thanks Todd,
    I am going

    Thanks Todd,

    I am going tomorrow.  I will def ask about the location since it does say two different places for the location and how that would afffect the surgery. I did not know that it was on the large side for a cyst.  What is a large size for a cyst? Guess I will ask that tomorrow too. 

    Kim

  • todd121
    todd121 Member Posts: 1,448 Member
    daisybud said:

    Thanks Todd,
    I am going

    Thanks Todd,

    I am going tomorrow.  I will def ask about the location since it does say two different places for the location and how that would afffect the surgery. I did not know that it was on the large side for a cyst.  What is a large size for a cyst? Guess I will ask that tomorrow too. 

    Kim

    Large Cyst

    What do I know? I didn't go to medical school! :)

    I'm not sure, really. I'm just going based on posts we've seen here on this site with regards to this being large for a cyst. This seems to be the size (2cm) where it gets urologists excited. Small cysts are common and are even more common as people age. And they can get large, even quite large. I think you should ask your doctor this question!

    Take someone with you when you go to your appointment. It's a great idea to have someone there to help you make sure you get all your questions answered. Also, write all your questions down and don't be embarrassed to use a checklist to make sure you get all of your questions answered. You don't get that much face-to-face time with the doctor. You want to take full advantage of it.

    Best,

    Todd