New Here, Solid 2cm Mass on Kidney Found

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hello to all - I arrived here out of sheer frustration at the medical community . . . i have been having upper right abdominal pain for some time, just started having lower back aches all day. My GP totally blew me off, so made an appt with a gastro - while looking for tummy problems he discovered a 2 cm solid mass via ultrasound almost 2 weeks ago. Last week I had a CT with and without contrast done, i phoned today and was told that the CT showed the same thing as the US, and they could not tell me if it is benign or malignant from what they saw, only that it is solid. They suggested I call a urologist or nephrologist for a consult. almost 2 yrs ago i had a abdominal ultrasound, and the kidney was clear - so i am assuming this is growing about 1cm per year. How will someone know if this is cancerous?? This waiting and wondering is driving us nuts here . . . thanks in advance . . .

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Trishpm

Most solid masses in the kidneys are cancerous. However, it is sometimes hard for radiologists to tell if a small mass is solid or fluid filled; at 2 cm, your's is about the smallest size that it is possible to tell cystic (fluid-filled) from solid. Because most solid kidney masses are cancerous, they are not usually biopsied. Depending on where the mass is in your kidney, you will want to consider a partial nephrectomy by an experienced surgeon, which will save most of your kidney. You will also need a CT scan of your chest to be sure that the cancer has not spread; because of its small size, the chances that it has spread are very small. In any case, the mass in your kidney is very small, and if you have surgery, you stand a very high chance of never having the kidney cancer return. My sister had a 2.5 cm solid cancerous kidney tumor removed 11 years ago and has never had a recurrence. There is an email support list specific to kidney cancer. Join it at http://cancerguide.org/kofaq/ .

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Jillhumb

thanks so much for your response . . the thing that seems a bit strange to me, i was hospitalized for 10 days in early may for a hypertensive crisis, and had a US of abdomen, a CT of abdomen, as well as an MRI of abdomen, and nothing at all showed up. Is it possible this small tumor has grown to 2 cm in that short amount of time??? or did they possibly miss this?? I was told yesterday that i must find a urologist to confer with.

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Trishpm

You do need a urologist, and one with experience in doing partial nephrectomies; you should not need to lose a whole kidney for a small mass. A very small but growing number of urologists have enough experience with laparascopic (lap) partial nephrectomies to do them competently; a laparscopic partial has a faster recovery time but needs more skill on the part of the surgeon. A partial needs to be done quickly because while the kidney is being cut, the blood supply to it needs to be interrupted (ischemic time), and if it is cut off for too long, the kidney can be injured. Usually it is easier for a surgeon to work quickly with an open vs a laparoscopic surgery. Ask a urologist who proposes doing a lap procedure what his average ischemic time is; it should not exceed a half hour in most cases. Frequently CT scans done for reasons other than to find a suspected kidney mass do not use IV contrast (injected into a vein, not the stuff you drink), and that makes it harder to "see" a kidney mass that may be close to the same density of kidney tissue. An abdominal CT scan with IV contrast makes the kidney mass more noticeable on the films; it may have been missed if the first CTs were done without contrast. You might want to get copies of the radiology reports of the CTs, ultrasound and MRIs to see if the latest films were compared with the older ones; if not, ask that a radiologist compare the sets of films. See http://tinyurl.com/p42rf for a technical medical discussion of indeterminate kidney masses. You should also know that kidney tumors can cause elevated blood pressure; frequently the blood pressure returns to normal after the mass is removed. Also, a very quick growing mass can be cystic and benign. I would urge you to join KIDNEY-ONC (http://cancerguide.org/kofaq/ ) if you haven't already; listmembers can answer your questions.

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Trishpm

You can find a urologist near you who has experience in treating kidney cancer patients by calling the Kidney Cancer Association at 800-850-9132; however, there are some excellent urologists who are not on their list.

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Jillhumb

i did join the list, and thank you! the ct was done w/ contrast, i am going up to the hospital tomorrow to get a copy of the report(s), as i'm very interested to see them. i've had high bp for awhile (runs in the family) but it escalated terribly at the end of april, and i ended up in ccu for 9 days in may. I'm on medicaid, so i'm probably limited to what urologist/surgeon will accept medicaid, many docs around here do not, so that stinks for me. i would love to have the lap instead of open, i've had 6 previous open abdominal surgeries, and have a real problem now with internal adhesions, so wondering if that might pose a problem with a lap procedure. all the info provided here has been extremely helpful, thanks so much

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Trishpm

Adhesions from previous surgery can prevent successful completion of a lap procedure. However, most surgeons will tell you that this is a possibility, and that they will convert to an open procedure if necessary during surgery.

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Weadocm

a very experience urologist in partial neuprhectomy's, laproscopic (even robotic) and ablation is Dr. V Patel at OSU James in Columbus. He's a leader in his field.

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Charle

On 7/4/2006 Trishpm wrote:

You can find a urologist near you who has experience in treating kidney cancer patients by calling the Kidney Cancer Association at 800-850-9132; however, there are some excellent urologists who are not on their list.

Trishpm,

I am seeing a urologist that I love (2nd opinion) who has spent an unbelievable amount of time over 1hr at office visits with my husband and me and showing us my CT & MRI films twice! My husband is very worried since I will be having surgery on R kidney to remove a sm. 1cm density, but at the same time having a hysterectomy. Both are to be laparoscopic surgeries. MD doing hysterectomy operated on me 2 1/2 years ago for D&C and hernia repair (6x5 inch piece of mesh in the way of my pending surgeries now). To reassure my husband I have been trying to research my urologist and latest info on AIM DocFinder, as of 3/19/07 states has no hospital privileges. My husband doesn't feel this MD has enough experience (he's young 33 y.o). He has explained procedure to me (I am also a medical assistant). I discussed doing open procedure since I have the "mesh", also several past abdominal surgeries, adhesions, etc. I talked about risk of infection and blood loss. Urologist stated open procedure to do both surgeries would require vertical incision from pubic bone up past belly button. I don't want this since I have C-section scar and 2 laparotomies (horizontal scar already). You seem to be very knowledgeable and I wonder what you thought about laparoscopic hysterectomy and then incision for partial nephrectomy? Thanks for your help.

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swtjean

Can I get an update as to how you are doing now? I have a renal tumor/mass. I find out which in about 2-3 wks. They found it in an abdominal US and now my GI Dr. is making an appt for a 3phase ct scan.

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