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Am I Jumping the Gun?

Big Sarge
Posts: 7
Joined: May 2017

 

A few days ago I had an MRI ordered by my pain management doc.  I have experienced severe lower back pain for a number of years due to a combat injury (IED) and have gone through numerous Prolotherapy, RFA and Epidural injection treatments.  The pain has not diminished.  So, the doc ordered an MRI to determine his next course of treatment. 

Two days after the MRI, the nurse called and said the doc wants me to get an Ultrasound and another MRI w/contrast.  She said the radiologist said he found some “lesions” in my right kidney and wants to look “deeper” into my back area.

 I am an investigator by profession.  I had no idea what a kidney lesion was during the phone call with the nurse.  So, I did some research on kidney lesions.  That scared me a little.  So, then I did what any good cop would do, I went to the nearest military medical clinic (I am active duty military) and said I needed a copy of the radiology report for my MRI so I could send it up to xxx to add to my medical file.  The nurse was hesitant and asked if the doctor had reviewed the report with me.  I sort of stretched the truth and got the report. 

The report findings listed a bunch of stuff regarding degenerative disc, wedging of vertebral bodies, disc height loss, loss of normal lumbar lordosis, etc.   

Then there are two notes I suspect are related to the “kidney lesions” my back pain doc’s nurse mentioned when she asked me to schedule additional scans. 

  1. There is a 2.4 cm T2 intermediate intensity lesion within the right kidney, which is suspicious for a possible renal lesion within the collecting system since urine would be expected to be more T2 hyperintense.  Recommend ultrasound for further evaluation.

  2. There is a T2 hyperintense, T1 iso-to hypointense, STIR hyperintense lesion in the left pedicle of L2 (2:4), which measures 1.9 cm anteriorly-posteriorly by 1.4 cm superiorly-inferiorly by 1.2 cm transversely. Recommend contrast-enhanced MRI for further evaluation.

  So, the way I read this is, I have a mass on my spine and a mass in my kidney.  I did what everyone on this forum says not to do.  I Googled the heck out of all of these terms listed in the radiology report.  I must say, I am now more concerned than ever.  My Ultrasound was yesterday and the second MRI is Friday.  I suspect I will have to wait another week or so before anyone tells me what is going on.  The Army teaches you to wait, but in this case – it is excruciating.     

Any thoughts on the two notes listed?

 

icemantoo's picture
icemantoo
Posts: 3335
Joined: Jan 2010

Big Sarge,

You need the follow up scans and to see a Urologist. Suprised they are not doing a CT with contrast. As for the lesion on your Kidney it is small and if confirmed to be Cancer has an excellent chance of being cured by Surgery alone. Have no thougts to share on the spinal lesion and or whether it is related to the Kidney.

 

Icemantoo

Dutch1's picture
Dutch1
Posts: 152
Joined: Mar 2014

If the two spots are cancerous, you are lucky in that the spots are being caught early.  Early detection is very important as to successful treatment.  So, keep up with the pursuit as to what these spots are.  Get to the bottom of it.  I am no technical wizzard as to the ins and outs of kidney cancer, but I'm pretty sure that small lessions can be a number of different things besides cancer.  So, take a breath.  Assuming you've got good people looking at you, you will get to the bottom of this quickly.  Whatever is going on, you're getting to it early.  That's great.  You will be up tight about this until it's resolved, but I think that you can approach this with optimism. 

Best wishes.

Dutch

Big Sarge
Posts: 7
Joined: May 2017

Thank you Dutch!

Jan4you's picture
Jan4you
Posts: 1327
Joined: Oct 2013

Welcome Big Sarge, glad you found this forum. Thank you too for your service. 

FYI, I had a MRI first and it should've been a CT scan. So in my opinion you need to wait till your Urologist/surgeon tells you what THEY need. Probably a CT scan. MRI is more for the one on your spine is my understanding. But your doctor will know. 

Just know everything is scary until you have a certain diagnosis and a plan. So try really hard not to use up much needed energy worrying about the what ifs when no one has told you anything yet. 

We'll be here for you no matter what, if you would like us to walk this journey along side. you. Let us know and give us updates.  k?

Whew.. breathe now.. best you can!

Sending you HOPE and healing hugs,

Jan

Big Sarge
Posts: 7
Joined: May 2017

Thank you Jan.  I completed an Ultrsound and another MRI with contrast since I posted this.  Just waiting now until someone calles to let me know what's going on.

medic1971's picture
medic1971
Posts: 205
Joined: Sep 2015

Big Sarge,

Welcome to our group, hopefully you are just passing through.  I do not think these two findings are related.  With your history, I suspect the lesion on your spine is trauma related

As far as your kidney goes...  That I really don't know what to tell you.  You need a CT scan with IV contrast to know for sure.  Even if the mass in the kidney is something, it's only 2.4cm and that is small in the world of kidney tumors. 

Keep us posted and stay away from Dr. Google!  Dr. Google was been hit with over 10,000,000 malpractice cases in the past 5 years alone.

 

Medic

Big Sarge
Posts: 7
Joined: May 2017

Thanks Medic.  Yes, the back issues are combat related.  I was a lucky one.

APny's picture
APny
Posts: 1998
Joined: Mar 2014

I'm with Medic1971 and hoping you're just passing through. Lesions could be anything, from a harmless cyst to cancer but even if worse comes to worst and it's the second, at the size it is now it's very small and most likely taken care of by surgery alone. I also tend to think the spinal lesion is related to your back pain and most likely not cancer. Even if your kidney lesion turned out to be RCC at 2.4 cms it is very unlikely to have metastesized to your spine or anywhere else. It's so easy to be scared witless with these findings. Make sure you see a urologist who will order the appropriate tests. All the best to you!

Big Sarge
Posts: 7
Joined: May 2017

Roger.  Good to hear this.

Kat23502's picture
Kat23502
Posts: 179
Joined: Feb 2016

Without the contrast these results are less than ideal. For the kidney, all the intermediate intensity in the T2 images means is that it isn't likely fluid. However, without contrast they don't know what it is. There are some benign masses that we see that have a fat component which reads in a similar fashion.

 

As for the spine, there is something there. What that is is very difficult to say. On STIR and T2 images, there are many things that appear hyperintense. Contrast will better helps us in medical imaging differentiate things like an old fracture from something more serious.

 

If this is something, it's quite small and likely will involve a surgery to remove it. However, without contrast, these images are not ideal. This is what I tell my students. Think of an exam without contrast as walking around your house in the dark. You may see a vague outline of a table but you can't see specifics. When you turn the light on, you may see the detail of the table or you may see that table is actually a chair. So, let them turn the lights on and then go from there.

medic1971's picture
medic1971
Posts: 205
Joined: Sep 2015

I read your posts and I immediately start looking for the "Like" button, but soon realize that I am not on Facebook...   

Kat23502's picture
Kat23502
Posts: 179
Joined: Feb 2016

Hahah! Sometimes I wish Facebook had an "unlike" button:) 

CRashster's picture
CRashster
Posts: 241
Joined: Mar 2017

Sometimes, I like things just so I can unlike them. In the end, it means nothing, but I get satisfaction.

Big Sarge
Posts: 7
Joined: May 2017

Thank you Kat.

BoondockSaint's picture
BoondockSaint
Posts: 242
Joined: Mar 2017

Cool

I agree Medic......Kat is a valuable asset to us all. Here's to you Kat.

Kat23502's picture
Kat23502
Posts: 179
Joined: Feb 2016

Well thank you but it's not a problem. I want to help anyone I can, everyone here was so tremendously helpful when I was first diagnosed!

stub1969's picture
stub1969
Posts: 889
Joined: Jul 2016

my appreciation for Kat before.  Like Boondock said, you (Kat) are a valuable resource for us.  With deepest sincerity, thank you!

Stub

APny's picture
APny
Posts: 1998
Joined: Mar 2014

Kat, the walking around in the dark analogy was perfect! It really helps understand the point of contrast. Thank you!

Deanie0916
Posts: 403
Joined: Nov 2016

Welcome to this forum! I pray you have patience to wait this out and I pray that they find out your lesions are benign. And like others have said above, the size is small so if it is anything, it has been caught early. Hope and peace to you!

Big Sarge
Posts: 7
Joined: May 2017

Thank you Deanie.  Hoping for good news, so I can focus on retiring from the military this year and going fishing!

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