Should I biospy

Clmac

I had been experiencing extreme fatigue, ankle and feet swelling and just general sick feeling. I had a CT w/contrast and it was recommended to follow up with renal ultrasound for further eval. The U/S revealed a 4cm "structure" with internal separation. My GP says a biopsy to be safe because CT shows "hyperdensity". Anyone have input ? 

icemantoo

Follow up

clmac,

 

My initial reaction is no based upon what I have seen on this board. But first a 4cm whatever it is should be evaluated by a Urologist, not a GP. That is my tought. Go from there.

 

Icemantoo

lcsvb

I agree with Icemantoo

Go straight to the Urologist. Most of the time a biopsy is not done because they are not very reliable. Most of us here had the "suspected RCC mass" surgically removed and then biopsied. I highly recommend a trip to a nearby urologist, especially if there is a cancer center you can get in at.

Clmac

Biopsy

Thanks guys, they are doing a referral to the urologist, hopefully will know more 

todd121

Clmac said:

Biopsy

Thanks guys, they are doing a referral to the urologist, hopefully will know more 

Kidney Mass

If you can see a urologic oncologist, even better. That's a urologist who specializes in kidney masses. 4 cm is pretty good size. Hopefully they can tell what it it is without biopsy or surgery. Kidney biopsies are hit and miss. I'd make sure whoever makes that decision knows what they are doing. A urologic oncologist is the best person to make this decision. My doc was a urologic oncologist who is a specialist in this area and he did not recommend a biopsy for me. My mass was over 6 cm.

The problem with kidney tumor biopsies is a positive helps, but a negative does not. A negative biopsy is confirmation of nothing. It's easy to miss the tumor, miss the cells within the tumor that are indicative of something.

Best of luck to you,

Todd

Clmac

todd121 said:

Kidney Mass

If you can see a urologic oncologist, even better. That's a urologist who specializes in kidney masses. 4 cm is pretty good size. Hopefully they can tell what it it is without biopsy or surgery. Kidney biopsies are hit and miss. I'd make sure whoever makes that decision knows what they are doing. A urologic oncologist is the best person to make this decision. My doc was a urologic oncologist who is a specialist in this area and he did not recommend a biopsy for me. My mass was over 6 cm.

The problem with kidney tumor biopsies is a positive helps, but a negative does not. A negative biopsy is confirmation of nothing. It's easy to miss the tumor, miss the cells within the tumor that are indicative of something.

Best of luck to you,

Todd

Biopsy

Thanks Todd,

I agree with all that you've said..I had thyroid cancer and the biopsy was a negative result, the pathology post-op was papillary cancer so I'm apprehensive about the whole ordeal. The not knowing an "inconclusive" is worrisome...and the fact it was called a 'structure'.. I deeply appreciate everyone's input.

Clmac

Biopsy

And auto correct messed up original post , should have said "internal septation"..did anyone have that diagnosis initially?

sblairc

Interesting. A CT with contrast suggests you need an ultrasound.

That's interesting, you had a more complex and thorough test used to diagnose kidney cancer and they are now recommnending an ultrasound.  Perhaps that's a good sign. Did your CT scan reference any "enhancement?" Usually these buggers light up on the scan as having vascularity (own blood supply) and it's mentioned in the report. Your information seems to suggest cysts or something (opinon strictly based on my reading here from others experiences). 

hardo718

Welcome Clmac

Sounds like my initial CT results and my urologic/oncologist referred to it as a "complex cyst".  The doctor I initially saw said there was a 80-90% chance it was cancer.  He was correct.  I got a second opinion, mainly because I didn't care for his bedside manner.  He dropped the cancer bomb on me and made no eye contact with me, just viewed the films on the computer the whole time. 

Good luck and keep us posted.  I'll keep you in my prayers.

Donna~

Clmac

sblairc said:

Interesting. A CT with contrast suggests you need an ultrasound.

That's interesting, you had a more complex and thorough test used to diagnose kidney cancer and they are now recommnending an ultrasound.  Perhaps that's a good sign. Did your CT scan reference any "enhancement?" Usually these buggers light up on the scan as having vascularity (own blood supply) and it's mentioned in the report. Your information seems to suggest cysts or something (opinon strictly based on my reading here from others experiences). 

Ct

The CT w/contrast was for another issue and the kidney was an incidental finding.. I'm in rural TN, probably not the best healthcare lol. It says there are hyperdense areas and hypoenhanced.  The finding concludes "within the lower right pole of the right kidney a relatively high density structure is seen . further characterization with renal ultrasound is suggested. That was last Monday, and I had the ultrasound on  Friday, with the results I discussed earlier. A 4cm "structure" (and i have no idea why they keep using that term )in the lower pole of the right kidney with internal septation. 

Clmac

hardo718 said:

Welcome Clmac

Sounds like my initial CT results and my urologic/oncologist referred to it as a "complex cyst".  The doctor I initially saw said there was a 80-90% chance it was cancer.  He was correct.  I got a second opinion, mainly because I didn't care for his bedside manner.  He dropped the cancer bomb on me and made no eye contact with me, just viewed the films on the computer the whole time. 

Good luck and keep us posted.  I'll keep you in my prayers.

Donna~

I hope you're doing well

I hope you're doing well Donna:) I have nothing to go and on and just have major concerns as my grandmother had her right kidney removed at 27 yrs old and I've had thyroid cancer..now I think I'm just paranoid !

foroughsh

Don't make worst conclusions,

Don't make worst conclusions,

If it's a kidney tumor then it's not recommended to have biopsy, it's not needed because it can be recognized by CT scan with/ without contrast and also having biopsy might give you wrong result and spread out.

A4cm mass -even if it's malignant- is treatable, it's probably stage  one and it's the best news you can expect with almost 85℅ of cure just after partial or radical surgery.

What you need is a urologist who is experienced with kidney cancer. Then trust your doctor and get ready for your treatment.

It might turn out to be benign, we've had such examples on this board

Keep us posted

Forough

sblairc

Clmac said:

Ct

The CT w/contrast was for another issue and the kidney was an incidental finding.. I'm in rural TN, probably not the best healthcare lol. It says there are hyperdense areas and hypoenhanced.  The finding concludes "within the lower right pole of the right kidney a relatively high density structure is seen . further characterization with renal ultrasound is suggested. That was last Monday, and I had the ultrasound on  Friday, with the results I discussed earlier. A 4cm "structure" (and i have no idea why they keep using that term )in the lower pole of the right kidney with internal septation. 

Ok, I understand.

What an unusual term to use, "structure" So vague and un-medical I would call and ask.  I bet your urologist appointment will clear things up. Do you know why your grandma had her kidney removed? Make sure you tell your urologist that. Keep us posted!

Clmac

Thanks !

Urology is next  

Clmac

sblairc said:

Ok, I understand.

What an unusual term to use, "structure" So vague and un-medical I would call and ask.  I bet your urologist appointment will clear things up. Do you know why your grandma had her kidney removed? Make sure you tell your urologist that. Keep us posted!

Structure

I have no idea , its unnerving to see that too ! Should get a urology consult within the week and go from there..I think my GP is causing unnecessary worry based on this discussion:) I'll be happy to just get definitive answer

mrou50

Not much to add

I just wanted to reiterate what everyone else has said get and expert to assist you not a GP, and I wish you good news with this.

 

Mark

hardo718

Clmac said:

Structure

I have no idea , its unnerving to see that too ! Should get a urology consult within the week and go from there..I think my GP is causing unnecessary worry based on this discussion:) I'll be happy to just get definitive answer

Structures

Maybe you have an architect hanging around in there....haha!  Try not to get too hung up on the terminology.  Sounds like they need more clarity as to what they are looking at and what you have growing in you.  In a sense, it is a structure I guess, cells are arranging themselves in the form of a growth much like bricks in a building. 

The important thing is to find out from a specialist if this is something that needs to be razed, much like a building that's housing squatters.

Looking forward to hearing your follow-up.

Donna~

Clmac

Thanks

Waiting to hear back for urology referral;)

Footstomper

Clmac said:

I hope you're doing well

I hope you're doing well Donna:) I have nothing to go and on and just have major concerns as my grandmother had her right kidney removed at 27 yrs old and I've had thyroid cancer..now I think I'm just paranoid !

We're all paranoid here!

Anyway you're not paranoid if its true

Clmac

Footstomper said:

We're all paranoid here!

Anyway you're not paranoid if its true

Paranoia!

Trying so hard not be !! But, I'm high anxiety by nature and this multiplied it by 10

Clmac

hardo718 said:

Structures

Maybe you have an architect hanging around in there....haha!  Try not to get too hung up on the terminology.  Sounds like they need more clarity as to what they are looking at and what you have growing in you.  In a sense, it is a structure I guess, cells are arranging themselves in the form of a growth much like bricks in a building. 

The important thing is to find out from a specialist if this is something that needs to be razed, much like a building that's housing squatters.

Looking forward to hearing your follow-up.

Donna~

Architecture

Lol ! Thank you Donna ! 

Also, did your initial diagnosis mention "internal septation"?