36 w/renal mass & liver lesions - thoughts & advice appreciated

Hi everyone. I feel like I have no one to turn to who understands what I am going through. I have a small solid mass on my right kidney that was discovered incidentally on a CT scan in March 2017. I had an MRI and the radiologist said it could represent a renal oncocytoma, metanephric adenoma or renal cell carcinoma and recommened continued follow-up. At the time of my September 2017 MRI, the radiologist said the mass appeared to be stable and contained fatty elements and likely represented an angiomyolipoma. My recent MRI on 10/1 showed the mass grew slightly, now measuring 1.7 x 2 x 1.6, and liver lesions were also discovered. The radiologist said the lesions were not seen or significantly increased in size compared to the prior report, and are concerning for metastatic disease, however, other lesions such as focal nodular hyperplasia and hepatic adenoma can give a similar appearance.

Since the 10/1 MRI, I had bloodwork which came back normal. I was referred to a Urologist. There were traces of blood in my urine (hematuria). He didn't seem concerned and said benign kidney and liver lesions are common. I had another MRI on 10/8 with Eovist contrast to get a better look at the liver lesions. I have five lesions that measure 1.9 x 1.9 cm, 1.3 x 1.4 cm, 1.6 x 1.3 cm, 1.1 x 1.0 cm, and .7 x .7 cm. The radiologist was able to find one lesion on the March 2017 scan, but said the others are new. My doctor recommended a PET CT scan and referred me to a liver specialist.

I had the PET scan on October 16th. No FDG localization was demonstrated in the liver or kidney. Per the radiologist, this may represent a benign/low-grade process in the liver, but hepatocellular carcinomas may not be FDG avid. He also noted that the kidney is difficult to assess on PET scans. He recommended a biopsy or short-term follow-up of the liver, and a short-term follow-up sestamibi exam of the kidney. A 3 mm nodule was also found on my right lung. I had my consultation with the liver specialist and follow-up with the Urologist on 10/18. My Urologist is suggesting a biopsy or follow-up scan of the kidney in 4-6 months. I gave another urine sample and it was again positive for traces of blood. My liver doctor wants an endoscopic biopsy, and this is scheduled on 11/7. My PCP wants a CT in 3 months of the lung.

At this point, I am anxiously waiting for the biopsy and results of my last urine that were sent to a lab for further testing. I am really worried about taking the right steps. I plan on reaching out to both doctors tomorrow to ask why I am having a biopsy of the liver first and not the kidney. I have read that there is a risk of cancer cells reseeding during a biopsy. I'm not sure how true this is, but there really is no other option to get a tissue diagnosis. My primary seems worried but the specialists seem to think they are likely benign due to my age and no other symptoms. I don't know if they are just trying to be positive so I don't worry, but I have lesions in my kidney, liver and lung, so of course I am worried.

I would love to know your thoughts and appreciate any advice you can give. You can also click on my name/photo to read my story. Thanks!