Original CT scan shows mass, US shows mass, CT scan with and without contrast does not show mass...

ybrown
ybrown Member Posts: 9
in Kidney Cancer #1

I was taken to the ER with upper neck and arm pain. While in the ER, a CT scan was done on my abdomen to check my lungs and heart. The scan came back with a mass on my kidney. I've been diagnosed with a Bosniak II cyst and a simple cyst previously so my GP and I both assumed it was one of them that showed up again. Since the ER radiologist mentioned the mass, my doctor said I have to have an ultra sound just to confirm. Had the ultra sound and during the scan, the technician asked the student tech to go get another technician. The technician literally said "do you see what I see?" to the other tech. My GP contacts me the next day and says "there was a cyst in the right kidney and a smaller solid appearing area in he midportion of the right kidney. This solid appearing area was not on the previous ultrasound. The radiologist is recommending, and I concur, to do a CT scan to get a better lookat this area." At this point I am getting a bit nervous. I do the CT scan with and without contrast and the results from my GP were "CT scan demonstrated no mass in the kidneys..." I got a copy of the results myself and the radiologist stated there was a small area that could not conclusive. Now my question is, how can two scans show one thing, then another show absolutely nothing?

Comments

  • icemantoo
    icemantoo Member Posts: 3,361 Member
    #2
    My thoughts

    ybrown,

     

    Have the same radiologist read both scans. If they can not be reconciled and the mass is small the doctor may suggest waiting a few months or up to 6 months for a new scan/ By small I mean the area of concern is under 2 cm.

     

    Icemantoo

  • ybrown
    ybrown Member Posts: 9
    #3
    icemantoo said:

    My thoughts

    ybrown,

     

    Have the same radiologist read both scans. If they can not be reconciled and the mass is small the doctor may suggest waiting a few months or up to 6 months for a new scan/ By small I mean the area of concern is under 2 cm.

     

    Icemantoo

    Mass

    The radiologist report stated "A smaller solid-appearing lesion in the mid to lower pole measuring 13 mm in diameter. The smaller lesion did appear to have detectable blood flow and is worrisome for a primary renal neoplasm..."

  • todd121
    todd121 Member Posts: 1,448 Member
    #4
    ybrown said:

    Mass

    The radiologist report stated "A smaller solid-appearing lesion in the mid to lower pole measuring 13 mm in diameter. The smaller lesion did appear to have detectable blood flow and is worrisome for a primary renal neoplasm..."

    It's Small

    But you should keep an eye on it. Are you seeing an urologist/urologist oncologist? You should see one and have it monitored. They will want to rescan in 3-6 months I would guess.

    If it's in the midpole, pay close attention to it. That's where all your blood supply goes in/out of the kidney. You don't want something growing fast there. Less worrisome if it's clearly in the upper or lower pole. But either way you want to be monitored by someone that knows what these things are. A urologic oncologist is the best person for this I think.

    Todd

  • ybrown
    ybrown Member Posts: 9
    #5
    todd121 said:

    It's Small

    But you should keep an eye on it. Are you seeing an urologist/urologist oncologist? You should see one and have it monitored. They will want to rescan in 3-6 months I would guess.

    If it's in the midpole, pay close attention to it. That's where all your blood supply goes in/out of the kidney. You don't want something growing fast there. Less worrisome if it's clearly in the upper or lower pole. But either way you want to be monitored by someone that knows what these things are. A urologic oncologist is the best person for this I think.

    Todd

    Urologist

    I have a urologist that I was seeing until 2013 because of a Bosniak II cyst. This baby came out of the blue and it is located mid pole. I'm calling my urologist tomorrow for an appointment. 

  • todd121
    todd121 Member Posts: 1,448 Member
    #6
    ybrown said:

    Urologist

    I have a urologist that I was seeing until 2013 because of a Bosniak II cyst. This baby came out of the blue and it is located mid pole. I'm calling my urologist tomorrow for an appointment. 

    These tumors usually grow quite slow. According to my surgeon's website:

    http://www.kidneycancerinstitute.com/active-surveillance.html

    They tend to grow at a rate of 0.1 to 0.8 cm per year.

    The above website is a great overview of kidney masses, types, and different kinds of treatments.

    Todd

  • GSRon
    GSRon Member Posts: 1,303 Member
    #7
    todd121 said:

    These tumors usually grow quite slow. According to my surgeon's website:

    http://www.kidneycancerinstitute.com/active-surveillance.html

    They tend to grow at a rate of 0.1 to 0.8 cm per year.

    The above website is a great overview of kidney masses, types, and different kinds of treatments.

    Todd

    Maybe this will help..

    Maybe this will help..  http://www.med.umich.edu/lrc/coursepages/m1/anatomy2010/html/clinicalcases/renal_cyst/renal_cyst.html

    Cysts are very common in Kidneys and rarely cause any issues or become Cancer.  However this is why follow up is suggested.  Being your CT Scan with contrast did not light anything up, that is awesome news..!  

    Ron

  • todd121
    todd121 Member Posts: 1,448 Member
    #8
    ybrown said:

    Urologist

    I have a urologist that I was seeing until 2013 because of a Bosniak II cyst. This baby came out of the blue and it is located mid pole. I'm calling my urologist tomorrow for an appointment. 

    Sorry. I'm confused.

    I read back through what you've said, and when you quoted the radiologist as saying there was something 13mm, I thought you meant the radiologist's comment on your CT. Now I'm guessing you meant on the ultrasound?

    The CT is much more accurate than the ultrasound. I don't see how something could show up on the ultrasound and disappear on the CT. 13mm is small, but not so small as to be missed by a CT.

    I'd say if it's not on the CT, then that's great news. Like Ron said, especially if it didn't light up with contrast, that's particularly good news.

    Todd

  • ybrown
    ybrown Member Posts: 9
    #9
    todd121 said:

    Sorry. I'm confused.

    I read back through what you've said, and when you quoted the radiologist as saying there was something 13mm, I thought you meant the radiologist's comment on your CT. Now I'm guessing you meant on the ultrasound?

    The CT is much more accurate than the ultrasound. I don't see how something could show up on the ultrasound and disappear on the CT. 13mm is small, but not so small as to be missed by a CT.

    I'd say if it's not on the CT, then that's great news. Like Ron said, especially if it didn't light up with contrast, that's particularly good news.

    Todd

    Thank you

    Thanks for the clarification everyone. I really appreciate everything...

  • JoeMoose
    JoeMoose Member Posts: 19
    #10
    MRI

    I originally had a CT Scan that showed sub centimeter cysts and nothing showed up on the ultrasound. I wanted an MRI to confirm that I had hermangiomas in my liver and spleen. Next thing I knew they say a mass in my kidney 1.7 cm. So I recommend going with an MRI at this point. I had a partial last week. I am thankful that I pushed for the last test as it was clear cell.

  • todd121
    todd121 Member Posts: 1,448 Member
    #11
    JoeMoose said:

    MRI

    I originally had a CT Scan that showed sub centimeter cysts and nothing showed up on the ultrasound. I wanted an MRI to confirm that I had hermangiomas in my liver and spleen. Next thing I knew they say a mass in my kidney 1.7 cm. So I recommend going with an MRI at this point. I had a partial last week. I am thankful that I pushed for the last test as it was clear cell.

    MRI

    They usually do a CT with and without contrast to diagnose this kind of cancer. Maybe someone else can explain why that is what they do instead of an MRI? I don't know the answer. However, I see over and over again that that's what people get on this board.

    MRI's are more expensive and the machines are fewer. But I think there's actually another explanation why CT with and without contrast is what they usually do when confirming this kind of cancer. I think Neil has even explained it in a previous thread...but it didn't stick in my mind.

    Todd

  • ybrown
    ybrown Member Posts: 9
    #12
    JoeMoose said:

    MRI

    I originally had a CT Scan that showed sub centimeter cysts and nothing showed up on the ultrasound. I wanted an MRI to confirm that I had hermangiomas in my liver and spleen. Next thing I knew they say a mass in my kidney 1.7 cm. So I recommend going with an MRI at this point. I had a partial last week. I am thankful that I pushed for the last test as it was clear cell.

    MRI

    Great advice. I will "suggest" an MRI when I meet with my urologist next week.

    Thanks a bunch.

  • mr68gto
    mr68gto Member Posts: 1
    #13
    todd121 said:

    MRI

    They usually do a CT with and without contrast to diagnose this kind of cancer. Maybe someone else can explain why that is what they do instead of an MRI? I don't know the answer. However, I see over and over again that that's what people get on this board.

    MRI's are more expensive and the machines are fewer. But I think there's actually another explanation why CT with and without contrast is what they usually do when confirming this kind of cancer. I think Neil has even explained it in a previous thread...but it didn't stick in my mind.

    Todd

    My understanding of the

    My understanding of the reason for CT w/wo contrast for renal cyst dianosis is --- The Bosniak system with category 1 through 4 was developed with the criteria defining each category based on CT w/wo contrast. 

    Having read this on several sites it is also noted that MRI with contrast is more specific and clearer that CT w/wo contrast. This can result in an 'upgrade' of the original Bosniak classification diagnosis with respect to complex cysts.

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