Calcification on ultrasound of kidney

[noahlady]

I had an MRI on my back a month ago showing a bulging disk.  It also showed a huge cyst on my right kidney so I was sent to an Urologist.  An ultrasound was done but the Dr. said too much calcification was on the ultrasound to see good enough.  Now he wants another MRI on the kidney.  Does this mean I have calcification of the kidney? Or does it just mean the ultrasound was too cloudy to see anything good so he wants the MRI just on the kidney to see it better?  Thanks for answering.

[noahlady]

I had an appoint. with the new Dr. and he was very nice, professional, helpful, etc.  He ran the urine and blood tests and everything was normal.  He studied my MRI extensively he said and assured me that my chance of having cancer was less than 2%.  He was upset about the previous Dr.'s demeanor and was not in agreement with him in most of his diagnosis.  We are going to do a CT scan later next year since the cysts are so large and decide what to do then IF they have grown more.  He told me that I will have to have them checked probably twice per year from now on.  Thanks for listening.   Noahlady

[noahlady]

Hi, you asked me to let you know what happened.  Well, it wasn't "pretty".  That Dr. was rude, obnoxious, etc. etc.  I made appoint. to ask questions and for him to go over the MRI - for my info not to question his knowledge.  He got very angry - 1st that I was asking questions and 2nd that my husband went in with me.  The only info we could get out of him was that He said I had a 10% chance of having cancer.  He doesn't believe in biopsys, he wants to take the whole kidney out!  He said that blood tests and urine test, kidney function tests, etc. would not do any good because the cysts are on the outside of the kidney and not in it.  But he then added very flippantly that if I wanted a blood test or to pee in the pot then he would do the test. I asked him if we should wait 6 months until we do another MRI worried that waiting that long could become that 'point of no return' if I do have cancer.  He then said very angrily, well if you want me to schedule it tomorrow we will and if you want me to take out the kidney tomorrow I will.  I apologized for upsetting him and said that I was just asking for my info not challenging his knowledge.  He was angry that he had to go over the MRI for us too.  After that he just stormed out of the exam room and slammed the door. (I have been very kind in the way I told you how he was.)  Needless to say, I am going to another Urologist this week to get his opinion.  I'm not letting that one touch me with a 10 foot pole!  He must have skipped the classes of 'good bed side manner'.  What do you think?

[Dr Smitha Mathews]

Hi,

It is important that you get a report of the MRI. If possible, please post the details of the report on this forum.

First, I agree with you that any information regarding a patient's condition will need to be communicated by the doctor so that one has the option of clearing one's doubts and seeking reassurance regarding symptoms that may be worrying.

Second, with regard to the renal cysts, the doctor is partly right about the wait-and-watch approach. Kidney cysts can be complex or simple. Calcification can occur both in simple and complex cysts. The area of concern is that though simple cysts would not become cancerous, a complex cyst could be precancerous or part of a renal cell carcinoma.
As both the cysts, despite being quite large, have not caused any overt signs or symptoms, it would be better to wait for some time rather than proceed with the alternative. The alternative involves renal biopsy through surgical exploration. As this procedure does involve some amount of risk, it would be better not to initiate it unless one is sure that it is absolutely required.

Third, your doctor should have advised blood tests and kidney function tests, as well as blood tests looking for cancer-related changes. When you do go back for the consultation you can discuss these options with him. If he does not have the tests done, you can seek more clarification here.

regards

[noahlady]

I had another MRI done.  All the Dr. said was - thru his nurse not him - "he THINKS it is not cancer.  The wall of the kidney is very thick which he does not like, but he wants to monitor it so I don't need to come back in until Jan. of 09 for another MRI.  First of all, him possibly "thinking" it is not cancer says there is a possibility that it could be.  2nd, what does the wall of the kidney being very think and he doesn't like that actually mean?  3rd, how is he monitoring it if I don't have to come back for 5 months!  If it isn't cancerous now - it could develop over that so called monitoring time and he wouldn't know it.  The 2 cysts are 8 cm and 9 cm which are huge he said and both being on 1 kidney.  I think this lack of info is very unprofessional.  He didn't even tell me this with a consultation but thru his nurse calling me on the phone.  What did I really find out?!  Nothing!  I am very upset with this Dr.  How would he like it if a Dr. just told him this useless info?  I am going to call him to schedule a consultation in person for him to explain himself.  I know one Dr. doesn't like to discredit another Dr. but don't you think this was very unprofessional, unconcerned approach to a patient?!  I know that the medical field is more and more becoming just a business.  And after a Dr. earns alot of money it seems their lack of concern for their patients multiplies.  But it is those patients who paid them and built their business.

[Dr Smitha Mathews]

Hi,

Individuals older than 50 have an increased tendency to develop renal cysts. These may be simple or complex cyst.
Simple cysts do not need much or any intervention if they are not so big as to damage the kidney by the pressure they may exert on the normal kidney tissue. Surgical procedures for treating the cyst include deroofing of the cyst.

Complex cyst may be mistaken for renal cell carcinoma and may have precancerous potential.

Simple or complex cysts can undergo calcification over a period of time and may not require any intervention if they are asymptomatic.

An ultrasound does not help to visualize any structure as clearly as an MRI would. The MRI would also be able to detect the probable contents of the cyst and could aid in planning further intervention.

Do keep us posted.
regards,