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Cyst on right kidney
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Cyst on right kidney

I am a 62 year old male.  This week, I had an MRI done on my spine as a part of a routine physical.  My doctor (internist) told me that the MRI detected a large cyst on my right kidney.  I have medullary sponge kidneys, most notably in my right kidney.  I passed 3 stones in the late 60s and have not had any recurrences until about 4 years ago.  I passed 5 stones 4 year ago and have not been to a urologist since.  During this process, I had a lithotripsy (unsuccessful due to the size of the stones) and a stint in my ureter to allow my creatin level to return to normal (which it did).  I have had many kidney tests done, but none in the past 4 years.  Is there a likely "generic" prognosis for the cyst?  Is kidney cancer a strong possibility?  What are the ramifications of kidney cancer?  What is the cure rate?  Should I immediately see a urologist.  I tried to make an appointment, but the soonest I can be seen is mid-February.  I am in good health, but this report of a large cyst on my kidney concerns me.  I would appreciate any information that you can give me.

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A "routine" MRI is an odd test to have during a physical.  In any case, there are a lot of cases of kidney cysts that may be benign. In fact, kidney cysts may be present in 15 percent of males between the ages of 59 and 69.  

The MRI can suggest findings of cancer or a cyst.  If the findings are indeterminate, you may want to consider a biopsy to see whether it is a cyst or cancer.  

Regarding kidney cancer (renal cell carcinoma), treatment is usually determined by the rate of spread.  Either medical or surgical (i.e. nephrectomy) therapy is based on the biopsy as well as other studies determining if the cancer has spread.  

In any case, discussing the possibility of kidney cancer may be getting ahead of ourselves without a biopsy.  I would discuss the next step as well as your concerns with a urologist.

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.
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