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Urology (Expert Forum)
Re: Large renal cyst found
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Re: Large renal cyst found
by HFHS MD JL, Jan 01, 1995 12:00AM
Posted By HFHS M.D.-JL on May 06, 1998 at 17:10:56:
In Reply to: Large renal cyst found posted by Debra R. K on May 01, 1998 at 22:54:43:
I have had a renal cyst now for the past 20 odd years (diagnosed in 1978) I am now 45 yrs old and recently (starting in Sept. 1997) have been experiencing UTIs and hematuria about 3/mo. I have had problems with UTIs since my teen years.
Now going to Urologist, I have had UVP and ultrasound. The ultrasound showed the cyst had grown considerably. I looked at the "pictures" and at first was quite concerned it was cancer (NOTE: My doctor also was concerned with this) . The radiologist read the films and said it was a benign large upper qudrant cyst.
My question is this, what is the prognosis for this condition? I did have several smaller 'shadows' appearing on the ultrasound.
Dear Debra,
Cystic disease of the kidney can be classified in many ways. There are genetic and non-genetic cause of renal cysts. (Is there anyone else in your family with cystic disease of the kidney?) They may also be classified by there appearance by renal ultrasound and CT (CAT scan) as a benign simple cyst versus a complicated cyst. The most important issue with cystic disease is to determine if there is an associated cancer.
When the radiologist states that the cyst is "benign and large", he/she is using certain criteria. Renal ultrasound criteria are: 1) There is an absence of internal echoes--the cyst looks dark inside; there are no traces of white debris "echoes". 2) Sharply defined, thin, distinct wall with a smooth and distinct margin. 3) Good transmission of sound waves through the cyst. 4) Spherical or slightly ovoid shape.
If all of these criteria are met, there is a negligible chance that the cyst contains cancer.
Now, you also mentioned additional cysts. These cysts may harbor cancer and the best study to evaluate this is a CT scan. If there is cancer, the kidney may need to be removed.
If the cyst is benign and you have symptoms, you may need treatment as well. Symptoms may include an abdominal mass, pain, hematuria secondary to rupture into the collecting system (the draining tract of the kidney) and hypertension. The risks of these symptoms increase as the size of the cyst increases. Treatment may consist of watchful waiting (as you have done), cyst aspiration, cyst aspiration with sclerotherapy and percutaneous (through the skin) resection.
More individualized care is available at the Henry Ford Hospital and its suburban campuses at (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians notes and lab test results that you may be able to obtain. These will help us greatly.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
Sincerely yours;
HFHS M.D.-JL
* Keyword: renal cysts; simple renal cysts
In Reply to: Large renal cyst found posted by Debra R. K on May 01, 1998 at 22:54:43:
I have had a renal cyst now for the past 20 odd years (diagnosed in 1978) I am now 45 yrs old and recently (starting in Sept. 1997) have been experiencing UTIs and hematuria about 3/mo. I have had problems with UTIs since my teen years.
Now going to Urologist, I have had UVP and ultrasound. The ultrasound showed the cyst had grown considerably. I looked at the "pictures" and at first was quite concerned it was cancer (NOTE: My doctor also was concerned with this) . The radiologist read the films and said it was a benign large upper qudrant cyst.
My question is this, what is the prognosis for this condition? I did have several smaller 'shadows' appearing on the ultrasound.
Dear Debra,
Cystic disease of the kidney can be classified in many ways. There are genetic and non-genetic cause of renal cysts. (Is there anyone else in your family with cystic disease of the kidney?) They may also be classified by there appearance by renal ultrasound and CT (CAT scan) as a benign simple cyst versus a complicated cyst. The most important issue with cystic disease is to determine if there is an associated cancer.
When the radiologist states that the cyst is "benign and large", he/she is using certain criteria. Renal ultrasound criteria are: 1) There is an absence of internal echoes--the cyst looks dark inside; there are no traces of white debris "echoes". 2) Sharply defined, thin, distinct wall with a smooth and distinct margin. 3) Good transmission of sound waves through the cyst. 4) Spherical or slightly ovoid shape.
If all of these criteria are met, there is a negligible chance that the cyst contains cancer.
Now, you also mentioned additional cysts. These cysts may harbor cancer and the best study to evaluate this is a CT scan. If there is cancer, the kidney may need to be removed.
If the cyst is benign and you have symptoms, you may need treatment as well. Symptoms may include an abdominal mass, pain, hematuria secondary to rupture into the collecting system (the draining tract of the kidney) and hypertension. The risks of these symptoms increase as the size of the cyst increases. Treatment may consist of watchful waiting (as you have done), cyst aspiration, cyst aspiration with sclerotherapy and percutaneous (through the skin) resection.
More individualized care is available at the Henry Ford Hospital and its suburban campuses at (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians notes and lab test results that you may be able to obtain. These will help us greatly.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
Sincerely yours;
HFHS M.D.-JL
* Keyword: renal cysts; simple renal cysts
