Spot on Right Lung

My mother is 62 years old, lives in Colorado and has never smoked, does not drink alcohol and has never been overweight. About 2 1/2 years she was diagnosed with RCC Kidney Cancer. About 2 years ago she had her left kidney removed. She was free and clear of cancer until about a year ago. She has had TCC tumors show up in her bladder. The doctor has been cauterizing the tumors every three months and says they are very low grade, noninvasive and are not life threatening. Just recently the doctor did an overall CT scan on her and found a spot on her right lung. The spot is round and is 11 millimeters in size.  It is also dark and looks like their is a hole in the middle of it. The doctor has previously done chest x-rays on her and a spot has never showed up. The doctor does not know if this spot was there before the kidney was removed.  The doctor does not think this spot is kidney cancer because her abdonminal area and lymph nodes are clear. I know that cancer cells can spread through the bloodstream.  Can a blood test be done to confirm whether cancer cells are present? The doctor prescribed her antibiotics and will do another CT scan in about a month to see if the spot has decreased in size. What are the chances that this could be metastatic kidney cancer?

[National Jewish]

While unlikely, this spot on the lung could indicate the spread of renal cell carcinoma (RCC).  Biologic markers have been used for years to detect tumor activity for tumors other than RCC.  The development of such markers is quite recent.  The demonstration of such a marker might be used as evidence for and against this spot being RCC.

If this spot is near the surface of the lung, it might lend itself to an outpatient CT guided needle biopsy or aspiration.  It also might be diagnosable by video assisted thoracoscopy (VATS).  This is a minimally invasive inpatient surgical procedure in which the lung and surrounding tissues are examined through a scope with a small video camera at one end of a thin flexible tube.  This scope is placed through a small incision between the ribs into the chest.  During this procedure tiny pieces of lung tissue can be taken for further testing.  This is called a lung biopsy.  You should talk about this with your mother