u/Runners-Road3832

My cystic mass was found back in April of this year. CT report:

- Approximate 2.6cm transverse by 2cm CC by 2.1cm AP enhancing soft tissue mass with eccentric central cystic component (approximately 2cm transverse by 1.5 cm AP by 2.1 cm CC) seen in the lateral aspect of the right middle pole kidney, suspicious for cystic renal neoplasm (Bosniak 4: percent malignant 80%)

So I had my surgery Aug 13. Doc says it went beautifully and he feels he got the whole thing, expects that I am now cancer free. 🙂

The abdominal and incision pain hasn’t been too bad. I guess it’s about what I expected. However, word of warning in case someone else experiences this. The gas they used to inflate my abdomen traveled up to my lungs and irritated them. It was horrible painful and super scary because we didn’t know what was happening. Apparently it is called pleural irritation and can be a side effect of robotic PN. The pain was sharp and so intense! It went from my diaphragm up to my neck, all in my right side, which was my surgery side. Luckily, my IV hadn’t been taken out yet, so my nurse quickly gave me some dilaudid when she saw how much pain I was in. Even still, it took a while for it to calm down. I don’t share this to scare anyone, but for the knowledge of what it is. If I had realized what it was, I wouldn’t have been quite so sacred. I thought my lung had collapsed or something horrible.

They did stat chest xray, ekg and cbc. Doc quickly determined what it was and assured me that all was fine. My lab work was even better than the day before and my chest xray was excellent.

I only stayed one night in the hospital. They kept me until 4 pm the next day because of my episode of pain. I’ve been fine since I returning home. I slept well and showered this morning. Walking a little and sitting in our recliner. Eating and drinking well. I expect it will get better each day. Thanks to this group for all the support, especially @ok-star1807 and @quickray2 who let me know that I needed a urologist rather than a nephrologist. My primary care had referred me to the wrong type of doctor and I would have waited weeks more if it wasn’t for this group. Wishing everyone the best!

I have a 2.7 cm complex cyst, it’s a mass with a fluid filled cyst inside of it, that was classified as Bosniak 4.

Urologist at cancer center says it’s complicated, in a complicated location and appears to be both inside and outside of the kidney, though it hasn’t spread per my CT.

Has anyone had a category 4 to come back as benign?

I’m trying to decide if it makes sense to do a biopsy. My urologist says that there’s a small risk of cell spillage.

TIA!

48 y/o female. I want to give back to this helpful group by sharing my findings and I also have some new questions.

The issues:

#1. Mass found on ultrasound when searching for cause of flank discomfort and HBP. Followed up with CT which revealed: Approximate 2.6cm transverse by 2cm CC by 2.1cm AP enhancing soft tissue mass with eccentric central cystic component (approximately 2cm transverse by 1.5 cm AP by 2.1 cm CC) seen in the lateral aspect of the right middle pole kidney, suspicious for cystic renal neoplasm (Bosniak 3: percent malignant 55%)

#2. Splenomegaly 14.4 cm AP

#3. Incidental non-specific finding of 6 mm nodule lower outer quadrant of the right breast possibly representing intramammary lymph node. Correlation with mammography recommended.

My urologist upgraded my mass/cyst to Bosnaik 4 after his review of the scans. He says it’s complex and in a complex position. Says it’s both in and out of the kidney. For all these reasons, he thinks there is a 70-80% chance it’s cancer.

He doesn’t recommend biopsy because it has a fluid component as well and he feels there’s a small risk of spillage. Very low risk, but I’m not willing to take it.

He also said I could have an ablation, but again, the fluid component makes spillage a possibility.

Recommends partial nephrectomy as safest route and most likely to be curative. He uses Da Vinci robot. He’s very experienced with the robot. He said one night in the hospital. Said I should be prepared for the possibility of a radical in the event that partial isn’t good enough.

He says if I need more time to wrap my head around this, then he’s ok with surveillance for a little while. He would want a 6 month follow up.

My questions are these.

1. Do I see an oncologist at some point? If so, when does that usually happen?

2. Why is my spleen enlarged? I did ask him, but he said I should follow up with general surgery for spleen evaluation. I don’t want it out. I just want to know why it’s enlarged. Maybe something else is going on and if it is, I’d like to know before her operates. Anyone experience this additional issue?

3. He says the mass isn’t causing my HBP, but we haven’t found any other cause - even after seeing a cardiologist. However, it looks like a lot of you also experienced HBP that resolved after sx. Could he be wrong about this?

Anyone else with renal mass AND enlarged spleen (nonspecific finding). The CT doesn’t indicate there being any metastasis. Just states it’s enlarged. Would one cause the other? My GP didn’t really offer any insight.

Thoughts? My GP ordered this CT. I have to wait several weeks to see a nephrologist.

- Approximate 2.6cm transverse by 2cm CC by 2.1cm AP enhancing soft tissue mass with eccentric central cystic component (approximately 2cm transverse by 1.5 cm AP by 2.1 cm CC) seen in the lateral aspect of the right middle pole kidney, suspicious for cystic renal neoplasm (Bosniak 3: percent malignant 55%)

- Splenomegaly 14.4 cm AP

Awaiting CT results after the following ultrasound findings.

Interpolar right renal heterogeneous solid nodule 2.3 cm and further evaluation with dedicated renal CT
with contrast.

Paranoia is getting to me as I await the results because my pain is changing. I did have pain just on my right kidney area, BUT now I feel some pain in my left lower abdomen and in my spine. So now I’m scared it’s metastasized. However, my hope is that maybe it’s just referred pain. Can anyone share their own experience? The pain isn’t horrible and if I’m completely still it will go away.

Side notes: All this started with a massive spike of my TSH that was previously controlled hypothyroidism, followed by a sudden drop of my TSH and a sudden onset of high blood pressure. Splenomegaly was also found on my ultrasound, although I think it’s mild because the doc didn’t even mention it. All kidney function is normal at this time.

Thanks in advance! This group has been providing me with both comfort and knowledge that I’m so grateful for right now. In that stage where I can’t really say anything to loved ones yet because I don’t want to alarm them unnecessarily. ❤️