I don’t know what to think

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polluxx
Posts: 76
Joined: Thu Jul 10, 2008 9:41 pm

I don’t know what to think

Postby polluxx » Mon Mar 06, 2023 8:59 am

I usually get PET scans which say right at the top, “no evidence of metastatic cancer”. This time, my insurance would only pay for a CT scan because my signitara has been negative and my previous scans have been unremarkable.

The CT scan showed a hypoenhancing lesion on my kidney. It is currently too small to characterize. I haven’t contacted my oncologist, because I know it is a wait and see situation. I feel like the fact that it is solid means it is likely a met, but what I read says that colon cancer only rarely spreads to the kidneys.

I have mostly been successful putting it out of my mind, but I would really like to know the odds of it being a recurrence so I can make future plans. We need to move by the end of June, but if I am sick again, I’d like to move closer to my husband’s family.

Has anyone had a similar result?
Stage 3c
2/2020 Right colon hemicolectomy (invasive adenocarcinoma with micropillary features)
Moderately differentiated
Tumor size: 4.4 in greatest dimension Metastatic Carcinoma in 12 out of 28 lymph nodes
Extranodal extension identified
Margins negative

3/2020 Began 12 rounds of FolFox
9/2020 Finished FolFox
12/2020 PET Scan-NED
1-2021 ctDNA Test negative
5-2021 ctDNA Test negative
7-2021 ctDNA Test negative
9-2021 PET/CT Scan-NED

roadrunner
Posts: 471
Joined: Sun Jan 12, 2020 8:46 pm

Re: I don’t know what to think

Postby roadrunner » Mon Mar 06, 2023 1:27 pm

Why are you saying it’s solid?
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23

polluxx
Posts: 76
Joined: Thu Jul 10, 2008 9:41 pm

Re: I don’t know what to think

Postby polluxx » Tue Mar 07, 2023 9:02 am

This is the description on my results: “


Kidneys:Subcentimeter hypoenhancing lesion involving medial inferior pole of left kidney, too small to characterize. Right kidney is unremarkable.”

When I looked it up, I thought I read that hypoenhancing means solid, but maybe I’m wrong.
Stage 3c
2/2020 Right colon hemicolectomy (invasive adenocarcinoma with micropillary features)
Moderately differentiated
Tumor size: 4.4 in greatest dimension Metastatic Carcinoma in 12 out of 28 lymph nodes
Extranodal extension identified
Margins negative

3/2020 Began 12 rounds of FolFox
9/2020 Finished FolFox
12/2020 PET Scan-NED
1-2021 ctDNA Test negative
5-2021 ctDNA Test negative
7-2021 ctDNA Test negative
9-2021 PET/CT Scan-NED

roadrunner
Posts: 471
Joined: Sun Jan 12, 2020 8:46 pm

Re: I don’t know what to think

Postby roadrunner » Tue Mar 07, 2023 10:33 am

I am not a radiologist, so please take this with a massive grain of salt and certainly check with your oncologist—but in my view that describes a structure with low or no enhancement from the contrast. Thus, it would appear to be consistent with a very large group of benign findings, for example a small cyst (which are very common in healthy people). Generally, I believe that vascularization increases contrast enhancement, and is thus associated with renal malignancy. But this is “hypoenhancing,”—low or no enhancement—which is good in this context. For what it’s worth, even subcentimeter *solid* kidney lesions (which this doesn’t seem to be) are 44-46% benign in general. Also, as you are aware, primary (first) metastasis of crc to the kidneys is extremely rare (maybe even unheard of? And “when you hear hoof beats, thinks horses, not zebras.” And certainly not talking zebras : ) Finally, radiologists are supposed to put suspicious findings in context—noting the relevance of a concerning finding—and in my experience they generally do so. That didn’t happen here, apparently. If it were me, therefore, this would be a question for my oncologist, but not something to worry about. By the way, while this does not appear worrisome, it’s also perfectly understandable that you got a bit unsettled by it, as you just transitioned from one kind of scan to another, with different properties and context clues.

Of course, I’d invite others to weigh in if I’ve got anything wrong above. There are lots of considerations and complexities here, and as I said, I’m no radiologist.
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23


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