I am 47 F, non smoker. A very small carcinoid was detected and removed during a colonoscopy 9 years ago. I had routine colonoscopies annually at first and then simi annually. The last one was in 2007 and I was told I could wait 5 years until tne next one. I was so relieved. BUT...........(no pun intended)
Recently was hospitalized w/chest pain, leading to a CT. CT shows 3 nodules in lower right lobe. 20mm 10.4mm and 10mm. I had a PET scan last Wednesday and it revealed 4.0 SUV uptake in the largest nodule, the smaller ones did not show increased uptake at this time. There is additonal uptake in the right hilar region of 4x4 and I would like to know what the "hilar region" is. I cant find much info online about that.
Also noted by the PET is increased FDG focus uptake in a bowel loop in the lower right quadrant with max SUV of 7.3.
My doctor said that was a rather high level.
My question, Is it likely the colon cancer has returned and the lung activity is a indication of possible metatastic from the colon to the lung ??? OR could the lung have a new cancer that is not related to the colon cancer from 9 years ago???
I have 2 consults on the 12th of January, one with a Intervention Radiology for a biopsy of the lung nodule and one with
the Gastro doc for colonoscopy /biopsy??? I have read that SUV uptake levels over 2.5 stongly indicate malignantcy. Is this true and if so, is the 7.3 SUV level indicate it is a higher stage of colon cancer? Since i am not a smoker and never have been, I fear the lungs may indicate that the old colon cancer is spreading.
Thank you for any info you can share. I think waiting is harder than actually getting the actual diagnosis than getting on with a treatment plan.
Hilar region is an area present between the two lungs by the side of mediastenum where bronchial airway,bloodvessels to lungs,lymph nodes (important for metastatic spread)of lungs,nerves,cluster all together at this region.This region is very important to observe cancers in lungs which leave doctors some evidences suggesting them spread of cancer from other organs or cancers originated in lungs or other related complications.So thats the reason why doctors advice us to get a chest X ray,CT,PET scans done to observe this area.
As you stated that you had been undergone a colonoscopic removal of carcinoid,medically called apudomas,it suggests me to a different explanation and relation to your present problem.The carcinoid is some kind of a cancer that is some what malignant.These carcinoid tumors produce a chemical called Serotonin which is neutralised by liver.But if the serotonin is not neutralised then it gets into blood and finally ends up in lungs.This serotonin deposit may be a the key generator of some nodules in lungs which is called bronchial carcinoid adenoma.It can also be presented as Carcinoid syndrome,known clasically,which is a very important and frequent complication of colon cancer.It may be presented as symptoms like asthma,chest pain,dyspnea,wheezing,weight loss, for which you have been admitted into hospital.So carcinoid tumor SUV reportys suggest a malignant spread to lungs which shows us the relation between colon cancer and lung cancer.
So finally there could be metastatic spread of there enterochromaffin cells or serotonin from the previous colon cancer before you underwent surgery.or it may be recurrence of another cancer in the colon.So I advice you to get a chest xray taken and related tests for the staging of the present cancer in lungs.If its recognised early it is so easy to manage such problem.Early chemotheray suggested by an oncologist and pulmonologist expertised in oncology of lungs is needed immediately.
I appreciate your response. I had a lung needle biopsy the day before you posted your
reply and was in the hospital for 4 days due to a pneumothorax. Unfortunately the biopsy was inconclusive but the few cells they were able to get were defined as "abnormal". Are you a physician? You seem to know alot about this. Do you have a personal experience with Carcinoid syndrome or bronchial carcinoid adenoma?
I am scheduled for an endoscopy and colonoscopy on Jan 26 and hope
to have more information made available to me.
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