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
CT 3/22: Clear
Chest CT 5/19/22 Clear
6/20/22 TAE rectal polyp benign
CT/MRI 9/11 Clear
11/9/22: Rectal exam/scope Clear (2 yrs.)