Hi All..Nice to meet you....

angie328

Hi....I'm new to this site, in regards to posting anyway, but I've spent many days reading all the posts and I feel as though I know you all.....

So...here's a little bit about me.  My name is Angie...I'm 53 and on July 11th I went in for a CT scan w/wo contrast as prep. for an upcoming total hysterectomy.  Long story short....the CT scan showed a lesion on my left kidney...this was totally unexpected and on that day my life changed.  Below is my report:

FINDINGS:

Limited images obtained through the lung bases are unremarkable.

Pre contrast images demonstrate no calculi within either kidney or within either ureter.

No hydronephrosis is seen. A small exophytic lesion arising from the midpole of the left

kidney posteriorly is hyperdense measuring approximately 56 Hounsfield units on the

pre contrast images. Pre contrast images otherwise unremarkable.

Following contrast administration, the right kidney enhances homogeneously. The lesion

seen arising from the left kidney posteriorly demonstrates borderline enhancement with

a Hounsfield unit measurement of 71. This lesion measures approximately 9 mm in

maximal dimension. The left kidney otherwise enhances homogeneously.

Okay so....on 8/2 my Uro. sent me for a percutaneous core needle biopsy...he wanted to do ASurv. but I basically demanded the biopsy so I knew what the heck I was dealing with...well...results were inconclusive...here are the notes:

pathology report revealed no evidence of renal tissue or neoplasm. Diagnosis was skeletal muscle fibers and

small amount of neotissue. It was unclear whether pathology reports suggest that a renal lesion was not

biopsied or alternative explanation. Plan is to undergo repeat renal ultrasound in 3 months and

consider MRI at 6 months.

Well...as you can see..I'm still in the dark as to what this is....the radiologist that performed the biopsy said in his 32 yrs. he didn't think this was a tumor...so, wth is it??? My Uro. thinks it's very early abnormal tissue growth and is most likely very early stage RCC....just wanted to throw this out to the experts here, those that have been through it all and see what you think.

On a side note, my uro. said I am extremely healthy, labs were normal and I can go ahead with my hyster. surgery in Nov. My appt. with him for the US is on 11/11...

Sorry this was so long...I tend to be a blabber....LOL!  Love you all and would appreciate any thoughts....

Hugs,

Angie

icemantoo

My thoughts

Angie,

Never heard of the Hounsfield Unit and did not understand it when I googled it and read about it. That being said you have a little bitty 9mm something or other which appears from your Drs. comments too small to diagnose and probabbly too small too  biopsy. My thoughts for what it is worth are that your doctors wait and see approach with follow up scans is in Agreement with this Doctor of Law. Hopefully nothing comes of this and you do not have to join our club at a later date.

 

 

Icemantoo

Footstomper

My thoughts

Speaking as a mandolin player, I'd want it out while its still a tiddler. I guess at 9mm its not life threatening. You'll find that most people on this board were feeling great when their little guest revealed itself. Can you not have it removed at the same time as your other surgery? I would definitely trust your Uro over a general practitioner

Good luck

JerzyGrrl

Hey, Angie -

Welcome to the board, if not the club.

I don't know much but here's my take on whatcha got going on:

In the days before CTs (and even nowadays), most of us folks tried through life with all sorts of blips and blobs inside us, and we were pretty much content in our ignorance. Sometimes the blips and blobs got bigger, sometimes not. If they were going to one day be a problem, we usually found out after they were.

Nowadays, we have scans. Sometimes they're looking for one thing and find something else. That's what seems to have happened to you. 

Renal cell carcinomas like to show off when you get contrast and a scan. Their blood supply makes them sparkle a bunch. Yours doesn't appear to be a total diva, so it's sparkling a little bit (That's the Hounsfield numbers stuff). Also, it's small, sort of little raisin size. If it's not a total diva tumor, what is it? It could be a simple cyst or one that's a tiny bit complex. Or, it could be any number of other things, pretty much all of them benign or at least minding their own business for now. 

Not too many places do kidney mass biopsies, especially on wee bits of kidney lesions. It's hard to aim for, plus if they're convinced it's minding it's own business, they tend not to mess with them. Most of us on the forum only find out about what exactly our particular renal masses are once they've been removed via surgery and the pathologist has studied it.  

Size, appearance, location all make a difference as to how critical it is to get something out. When they're small, don't resemble RCC divas, and aren't in a location where they're interfering with function or structure, they're perfect candidates for "active surveillance," which is what is sounds as though your physicians are advocating for. That's in the range of Best Practices.

In the meantime, waiting can be aggravating. That's a given and something we're all experts about. If you really want a name for it, call it WTH, Fred, Skippy, or Hortense. Also, let it know that you are the human and it is the blip. In other words, your the boss of it for now. 

Hope this helps. If I wasn't able to provide any enlightenment, at least you ought to be confused on a much higher plane.

Keep us posted,

;-)

Jerzy

All the best with doing stuff and getting ready for your other surgery!

Kat23502

Hounsfield units are what we

Hounsfield units are what we use in CT to help determine the density of a mass. Water is less than 20 HU. Solid masses are those with higher hounsfield units (HU). On CT, enhancement is seen after contrast when the vascularity of either normal structures or masses "take up" the contrast. When a mass enhances after contrast administration that usually indicates it has vascularity. How much it enhances and in what pattern through which phase (those CT passes are phases of imaging) all help determine what type of mass it may be. For example clear cell renal cell carcinoma enhances quite a lot where as papillary renal cell enhances less. The accepted rule of thumb is anything greater than 10 HU of enhancement is questionable, anything over 20 HU is considered definite enhancement with the greater the jump the more enhancement. The 10-20 range is a gray area and depends on phase. Your mass is very small so that's good news! Without knowing the phase where those HU numbers were obtained I can't comment on how much enhancement that is because in the excretory phase enhancement is less overall. It definitely sounds like it enhanced to a threshold that is questionable. As for the biopsy, having been involved in performing many, it sounds as if they didn't go deep enough and so they only got muscle and other fascia and not kidney tissue or the mass. That's a pretty small lesion to have a biopsy on. Most of the time they come back inconclusive and patients end up following the same protocol they would have followed without the biopsy. Watch it closely, take it out if they suggest it, and with one that small, you should have an excellent outcome.

stub1969

Great resource

Kat--welcome to this site.  Your experience and background will certainly be helpful.  I read your introduction on another post and I must say how fortunate you are to have the job you have to find your mass the way you did.  I'm glad everything worked out for you and wish you continued good health.

Blessings,

Stub

hardo718

Kat23502 said:

Hounsfield units are what we

Hounsfield units are what we use in CT to help determine the density of a mass. Water is less than 20 HU. Solid masses are those with higher hounsfield units (HU). On CT, enhancement is seen after contrast when the vascularity of either normal structures or masses "take up" the contrast. When a mass enhances after contrast administration that usually indicates it has vascularity. How much it enhances and in what pattern through which phase (those CT passes are phases of imaging) all help determine what type of mass it may be. For example clear cell renal cell carcinoma enhances quite a lot where as papillary renal cell enhances less. The accepted rule of thumb is anything greater than 10 HU of enhancement is questionable, anything over 20 HU is considered definite enhancement with the greater the jump the more enhancement. The 10-20 range is a gray area and depends on phase. Your mass is very small so that's good news! Without knowing the phase where those HU numbers were obtained I can't comment on how much enhancement that is because in the excretory phase enhancement is less overall. It definitely sounds like it enhanced to a threshold that is questionable. As for the biopsy, having been involved in performing many, it sounds as if they didn't go deep enough and so they only got muscle and other fascia and not kidney tissue or the mass. That's a pretty small lesion to have a biopsy on. Most of the time they come back inconclusive and patients end up following the same protocol they would have followed without the biopsy. Watch it closely, take it out if they suggest it, and with one that small, you should have an excellent outcome.

Thank you!!

For clarifying the Hounsfield Units.  That is the most understandable description I've read!!

God Bless,

Donna~

angie328

Thank you all....

WOW...what a wonderful group...thanks so much for your input...very helpful for sure.....

I guess for now it's a waiting game....one that I WILL WIN!!!!  I'm glad that this was found while small...from what I've read, I know whatever this "thing" is, it will most likely have to come out if it grows...which is what the Uro. stated....I'm wondering though...if there is no size change over time, is it really safe to keep this thing on my kidney...that's what worries me...or would it be more harmful to remove it if it's just hanging out there doing nothing?

Thanks so much for all the responses....you guys are the BEST!!! I will keep you all updated and pray for all of us and for advances to finding a cure for this and all types of Cancer.

Hugs and Love,

Angie 

Teashea

Hi Angie

Wishing the best out for you. I hate to say welcome to the board under these circumstances. However there are many caring people here so you came to the right place.

angie328

Teashea said:

Hi Angie

Wishing the best out for you. I hate to say welcome to the board under these circumstances. However there are many caring people here so you came to the right place.

Thank you so much...waiting

Thank you so much...waiting is the hardest while not knowing a thing...counting the days until my first US after the CT finding in July....

I am SO THANKFUL I found this board....we have no children and when I try to talk to my husband he either walks away or is distracted by the tv and I feel so alone.  I cry when he is at work and act cheerful when he's at home...this board is amazing and helps me with my mental attitude....I honestly love you all and although I am new to this...you've all helped me in so many ways...whether with info. or inspiration...

Hugs & Love,

Angie