9mm lesion in kidney

[kathy8]

A left kidney lesion was incidently discovered via CT scan during my visit to the emergency room. I had a CT of abdomen and pelvis with contrast. Delayed images were obtained through the pelvis. 1mm, 3mm, and 5mm reconstructions were performed. Arterial and Venous phases were used in this scan. Findings showed quote: a 9mm low-density lesion is seen in the mid pole of the left kidney, which is too small to characterize. Both kidneys are, otherwise within normal limits without evidence for hydrophrosis. The kidneys demonstrate symmetric nephrograms. There is semmetric excretion of contrast bilaterally. No evidence for renal artery stenosis or dissection, unquote. I followed up with my primary doctor who ordered renal ultrasound, bloodwork, and urinalysis. All bloodwork and urine was completely normal. My ultrasound was unremarkable too. It showed no evidence of lesion or cyst or anything. My doctor recommended follow up with another ultrasound in 6 months and continued monitoring of symptoms and bloodwork/urine. So I am left with this unidentified "lesion" in my kidney. Of course my intense concern is renal cancer. I've read ultrasounds may not pick up small lesions, so watching and waiting for 6 months to a year seems dangerous especially if it is cancer, in terms of possible metastasis. Should my ultrasound have picked up this 9mm "lesion" if the CT scan did? Can a CT scan of kidney be incorrect in situations like this? My age is 31.Thanks.

[Kevin Pho, MD]

Ultrasound and CT scan are a pretty reasonable approach for a renal mass.  If the lesion remains indeterminate (i.e. no definitive diagnosis despite these tests), an MRI is normally performed as it is more sensitive.

Small lesions like the one you have (i.e. less than 1.5cm) are difficult to follow and there are no established guidelines.  If the MRI remains non-revealing, you can consider following it with serial imaging studies to ensure it is not growing.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[finelefree03]

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