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CT scan shows small "consider malignant until proven otherwise" spot

wifeandmomof3
Posts: 5
Joined: Sep 2017

The urologist is on vacation.  While we wait until next Tuesday, can anyone explain what the Hounsfield units mean and what we may be looking at as a next step.  We aren't in panic mode- just trying to understand what the likely next steps are (no big deal, wait and watch, remove part of it, etc).

 

A little history - he had testicular cancer in Dec 99 and again 8 years later.  Had radiation after the first time.   Surgery both times to remove.   Everything in between has been good.  Clear scans, clear blood work (including when he was diagnosed).  

 

We are at 20% of cost, he's had some back pain, and it's been 3 years since a CT scan so we requested one before his yearly follow up with oncologist last week.  Exepected to hear kidney or gall stones (both of which he has, neither should be causing much issues).  But were suprised to hear he had a concerning spot on the kidney.  

 

It read "developed a 11 mm solid nodule projecting exophytically from the posterior infeerior right renal old series 3 image 42. Hounsield units78-80 without washout." and further in the report "Interval development 0.4 mm com,plex solid appearing exophytic right renal cortical lesion posterior from the inferior right renal cortex image 42.  Although hemorhagic proteinaceous cyst may mimic solid lessions, this lession should be considedred potentially malignant until proven otherwise."

Ultrasound didn't show anything.  The urologist nurse said it is not uncommon for things to show in either/or CT scan and ultrasound.

 

Thanks!

 

icemantoo's picture
icemantoo
Posts: 3183
Joined: Jan 2010

Wife and Mom,

 

No rush at this time.  The possible Kidney Cancer issue is so small that it is probable too small to diagnose. at 11mm (1.1Cm) Don't  be surprised if the doctor does a follow up scan down the road. The survival rate for a possable kidney tumor that size are close to 100%. For now lets hope it is nothing.

 

Icemantoo

wifeandmomof3
Posts: 5
Joined: Sep 2017

Quick update in case anyone is in the same boat and wondering ... When we met with the urologist in Oct, he had not been able to see the scan, but from the report he felt like it was very small and in an area that could easily be "blasted" out with a probe if needed so watch and wait and do another u/s in 6 months.  A few days later he was finally able to see the scan and called to tell us that it was about the size of a thumbnail, still very small and could be "blasted" if needed, but he was scheduling another ct scan in 4 months.  Apparently he saw something that concerned him a little to change his tune about not wanting to expose him to more CT scans than necessary (he's had a lot over the years).  Anyhow, no sense worrying until there is something to worry about and it sounds like we wait until they decide it is time to go get it out anyway.  At least they are watching it.   He did his 4 month follow up CT scan last week.  Urologist is out of the office so waiting to hear more.   I have a copy of the actual CT scan because they did it at the oncologist office, but I'm not a dr so hard to tell anything :).   Don't have the radiology report though.

wifeandmomof3
Posts: 5
Joined: Sep 2017

Just in case someone else is in the same boat down the road .. the tumor has grown some, but it is still udner 2 cm so they want to do cyroablation on it.   Said about 75% of these are malignant.  Without complete removal to biopsy becuase it is still small, hard to conclusively know if malignant or not.  However, becuase he is still younger they want to go ahead and do the procedure while it is small.  They will likely try to biopsy first, but it will probably be inconclusive because of size.  Appt for mapping ultrasound and consult later this week.  Anyone have experience with recovery from this procedure?  Looks to be pretty quick and easier recovery.

Wehavenotimeatall
Posts: 479
Joined: Aug 2017

 I know things have changed a lot in the past 5 to 10 years but cyo ablation is not something I would volunteer to do.

If hubby is fit and wellish I would push to do the operation.

 

I would always have a doubt  at the back of my mind  if everything had been successfully removed

 

Sorry to hear about testicular cancer but that is another reason to ensure that everything is removed.... you do not want something  popping in how many ever years

 Again just my opinion 

You have lots of time to pick and choose what you would like to do.

 

I hope everything goes very well for you.

Annie

 

APny's picture
APny
Posts: 1905
Joined: Mar 2014

I agree with the above. Ablation is usually recommended for someone elderly, who is poor risk for surgery. The gold standard is to remove it and do pathology. Pathology is not possible with ablation. Since your husband has already had cancer I would not risk this with an ablation. I think a second opinion with a kidney cancer specialist would be a good idea. In any case, 1 cm is very small and if it is cancer, it's very slow growing. I would wait and see what the second opinion was then if suspected cancer, have a partial nephrectomy. Whatever you decide, wishing you both all the very best!

Shecka1121
Posts: 114
Joined: Apr 2015

Hi.  I had a 1cm tumor and my dr recommended a PN.  Cryolation has higher recrurrence rate. Suregery is hte gold standard if patient is healthy enough.  Best to you

 

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