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Not exactly anticipated outcome of my partial nephrectomy

thingone
Posts: 39
Joined: Feb 2019

I want to share a story of my robotic partial nephrectomy surgery that was performed at Stanford on Tuesday two weeks ago. I was supposed to get rid of a solid mass and drain the fluid of a simple cyst adjacent to it, since CT/MRI/US scans before the surgery indicated there was a small exophytic  solid lesion in posterior midpole measures 10 x 4 mm and there is a 2.9~3.3 cm simple cyst nearby it.  My surgeon told my wife before I woke up that he made some change on his original plan and decided to remove the cyst along with the solid lesion. Intraoperative ultrasound was performed for the surgical team during the surgery. There is a large multilocular septated cystic structure which extends to the renal sinus. The septation is thickened and contains a small amount of vascularity. I have mixed feelings about this change. My wife and I both believe this is an outcome better than we expected/anticipated. Does anyone here have similar story like mine?  I am anxiously waiting for the pathology report.  

Bay Area Guy's picture
Bay Area Guy
Posts: 385
Joined: Jun 2016

I can't comment on your procedure, but I was wondering who your surgeon was as I was treated at Stanford in 2016.  My urologic oncologist was Dr. Gill and my surgeon was Dr. Sonn.  Both were great.

I hope your recovery is going well.  I'm a little surprised that the path report isn't out yet.  My surgery was 6/22/16 and the path report posted on MyHealth on 6/27/16.

thingone
Posts: 39
Joined: Feb 2019

Thank you Bay Area Guy, My urologic oncologist/surgeon is Dr. Benjamin Chung who is the best out of the bests in my opinion. He has performed over one thousand of kidney surgery since he joined Stanford. He is very professional, compassionate, courteous, and caring. I specially want to thank Dr. Chung and his team to adjust his original plan and make informed decision at last minute to remove a potential complex cyst adjacent to the solid mass at little sacrifice of kidney function.  His nurse told me that the pathology report was still pending. I guess the report takes longer than usual since my case may be a little more complicated. Hopefully it would not take more than a couple of weeks.

 

 

eug91's picture
eug91
Posts: 156
Joined: Jan 2019

First off, great job on getting through your neph. Hope your healing is going well!

I don't have any specific advice other than wait for the pathology report. The fact that you got it out while it at that size when it's still so small is a reason to be optimistic. But you won't know for certain until the biopsy. 

Fingers crossed for you!

thingone
Posts: 39
Joined: Feb 2019

Actually, everything in the whole procedure went well. I can image how busy Dr. Chung and his brilliant team were even when I was fully unconscious.  I woke up in the afternoon with my wife smiling and holding my hands. I asked for nurse help to move and stand up in the evening and started to take the first walk with assistance from my wife in the earlier morning next day.  Blood test indicates that my creatinine level increased from 0.89 to 1.1 and that eGFR dropped from 95 to 74 before and after the surgery.  I am not sure if these data will be improved or not after fully recovered. I was discharged one day after the surgery as expected and arrived home after five hours car ride. I have learned so many things and taken many helpful advices found from this forum since I joined this incredible forum last Febuary, inclduing the one to use pillows protecting body during the car ride. Thursday and Friday were a little rough at home. I stopped taking the pain medicine by the 4th day. Walked 4-5 miles on Saturday and Sunday.  I increased my walking distance from 6 miles to 8 miles per day from Day 6 to 11. I believe what I learned from here that everybody heals at their own rate. Yes, nobody knows the truth until pathology report is out. Best wishes to you.

APny's picture
APny
Posts: 1949
Joined: Mar 2014

Wow, you're really walking a lot. That's amazing! Here's to a good path report. It's probably best they took out the cyst even if it's just a cyst, which it probably is. All the best to you!

thingone
Posts: 39
Joined: Feb 2019

I finally received the pathology report. It demonstrates two juxtaposed lesions that were removed out were benign and not cancer. The larger lesion, 3.3 cm in size, corresponds to a benign simple cyst. The constellation of findings on the smaller lesion, measuring 1.5 cm in greatest dimension is consistent with angiomyolipoma (AML). No malignant features (significant component of epithelioid cells, mitotic activity, or necrosis) are identified. All in all I am taking the result as incredible and unbelievable.

DanielQ's picture
DanielQ
Posts: 32
Joined: Sep 2019

Wow, this is amazing good news! Congratulations! 

Bay Area Guy's picture
Bay Area Guy
Posts: 385
Joined: Jun 2016

That's fantastic!  Always great to read good news.

eug91's picture
eug91
Posts: 156
Joined: Jan 2019

You couldn't have asked for a better report. Congrats! 

APny's picture
APny
Posts: 1949
Joined: Mar 2014

That's fantastic. So happy for you. What a relief.

stub1969's picture
stub1969
Posts: 800
Joined: Jul 2016

When they found my tumor, I asked my doctor if he was sure it was cancer.  He said, "No, but I'm 90% sure it is."  He then explained the 10% piece, which you fit under.  what a wonderful gift you have been given.  Go and enjoy your life!

Stub 

Bay Area Guy's picture
Bay Area Guy
Posts: 385
Joined: Jun 2016

I really, REALLY like the way you call what his path report says a gift.  What a great way to phrase it Stub.

thingone
Posts: 39
Joined: Feb 2019

Dear Eug, APny, Bay Area Guy, and Stub, Thank you very much for the good words. Yes, the surgery and the pathology result are all wonderful gifts. On my birthday after the surgery, I told my family that the surgery is the greatest gift that God gives to me, since the mass was detected at its early stage which is pretty much fully curable and I am treated by one of the best doctors in one of the best hospitals. I am so fortunate I found an amazing group of supportive individuals on this forum. It could have been much difficulty to go through this without them. I have learned a lot of knowledge that I never wanted to be familiar with before, which may help me again or my loved ones someday since approximately 40% of men and women will be diagnosed with cancer at some point during their lifetimes (based on 2013–2015 data). Best wishes to all of you and all folks in this forum. 

Angie1496's picture
Angie1496
Posts: 154
Joined: Sep 2017

It's awesome they removed the cyst too!  I am 2 years post R nephrectomy and last week found out a small cyst in my left kidney now has a mass inside it.  I am having a L partial nephrectomy in 2 weeks. Congrats on your great recovery and Path reports

thingone
Posts: 39
Joined: Feb 2019

Thank you Angie for the comment on my cyst removal. My renal cyst was initially identified as a simple cyst after CT/MRI scans. The three urologic oncologists I consulted to had the same oppinion how to treat it: simply drain it. It seems it grows from 2.9 cm to 3.3 com during tha last 10 months and starts to become more complicated. I am glad my surgical team made a informed decision atthe last minute. Yes, my recovery is on my right pace as everyone heals differentl.  I am so grateful I found this forum and got a lot of advices and information including tips to prepare myself physically and mentally for the surgery.  For the last ten months,  I swimed 2~3 times a week on average, total distance of 107 kM, traveled to Italy and Spain with my famil, had verious tough hiking and bckpacking trips including climbing Mt. Whitney. I believe all of these prepartion activiies worked out pretty well. Good luck to your coming surgery.                                     

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