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Urology (Expert Forum)
small mass on kidney; lots of discomfort/pain
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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.
small mass on kidney; lots of discomfort/pain
by Daniel321, Mar 10, 2004 12:00AM
Hello,
I am a 48 year old male, thin, and have always been in great health until last November, when my doctor was performing a routine annual checkup including deep palpation to the upper left abdomen. I felt a sudden sharp pain and since that moment my life has never been the same.
For four months I have constantly been feeling at minimum a mild discomfort somewhere between the upper left abdomen and flank, but often it builds into a very diffuse and STRONG steady burning ache that lasts for hours on end. The torment can be so bad that sleep is impossible and I can't think about anything else.
I have been through the following tests and procedures to try to find the cause of the discomfort/pain: colonoscopy, endoscopy, 3 CT scans, MRI, bloodwork, urine checks, fecal occult blood test, EKGs, MRI of spine, etc.
There is no relationship with the pain and my eating or type of food. I'm never constipated, my bowel movements are always normal and so is urine. Temperature and white blood count are always normal. All of my test results are normal and nobody can find anything suspicious, except that there is a 1 cm. mass of some kind on my left kidney "projecting from the left lower pole laterally."
The radiologists in my small town assumed a simple cyst but a doctor at a major clinic has recently said he believes it is not a simple cyst. He advised me to come back in 2 months for a new CT scan to evaluate it better.
Here are 4 questions that I have about this matter. Unfortunately, I have not been able to contact the doctor at the clinic about any of them.
1. Is it possible that such a small mass on my kidney could cause the kind of pain I'm describing?
2. Is it conceivable that the first doctor may have disturbed the mass by deep palpation, starting the onset of symptoms?
3. If the mass on my kidney is symptomatic, shouldn't I be seeking a quicker evaluation, rather than waiting 2 months?
4. If it can already be determined that the mass is not a simple cyst, why should I ever want to keep it anyway rather than schedule a partial nephrectomy right away? Isn't the risk of malignancy in anything besides a simple cyst at least 20% if not much greater?
Thanks in advance for any reply.
I am a 48 year old male, thin, and have always been in great health until last November, when my doctor was performing a routine annual checkup including deep palpation to the upper left abdomen. I felt a sudden sharp pain and since that moment my life has never been the same.
For four months I have constantly been feeling at minimum a mild discomfort somewhere between the upper left abdomen and flank, but often it builds into a very diffuse and STRONG steady burning ache that lasts for hours on end. The torment can be so bad that sleep is impossible and I can't think about anything else.
I have been through the following tests and procedures to try to find the cause of the discomfort/pain: colonoscopy, endoscopy, 3 CT scans, MRI, bloodwork, urine checks, fecal occult blood test, EKGs, MRI of spine, etc.
There is no relationship with the pain and my eating or type of food. I'm never constipated, my bowel movements are always normal and so is urine. Temperature and white blood count are always normal. All of my test results are normal and nobody can find anything suspicious, except that there is a 1 cm. mass of some kind on my left kidney "projecting from the left lower pole laterally."
The radiologists in my small town assumed a simple cyst but a doctor at a major clinic has recently said he believes it is not a simple cyst. He advised me to come back in 2 months for a new CT scan to evaluate it better.
Here are 4 questions that I have about this matter. Unfortunately, I have not been able to contact the doctor at the clinic about any of them.
1. Is it possible that such a small mass on my kidney could cause the kind of pain I'm describing?
2. Is it conceivable that the first doctor may have disturbed the mass by deep palpation, starting the onset of symptoms?
3. If the mass on my kidney is symptomatic, shouldn't I be seeking a quicker evaluation, rather than waiting 2 months?
4. If it can already be determined that the mass is not a simple cyst, why should I ever want to keep it anyway rather than schedule a partial nephrectomy right away? Isn't the risk of malignancy in anything besides a simple cyst at least 20% if not much greater?
Thanks in advance for any reply.
Doctor's Answer
by Kevin Pho, MD, Mar 11, 2004 12:00AM
, Mar 11, 2004 12:00AM
To answer your questions:
1) A kidney mass may be possible for your symptoms, but this should have been seen during the CT scans and MRIs you have received.
2) That is unlikely - and any lesion that is large enough to cause discomfort should be readily apparent on the imaging studies you have received.
3) If the imaging studies (i.e. MRIs and CT scans) are truly negative, then it is unlikely that such a symptommatic mass is present. Another opinion (preferably in a larger academic medical center) is always an option if the tests continue to be non-revealing.
4) Simple cysts are common anatomical abnormalities that are present in up to 30% of older adults. In most cases, they do not progress to cancer. There is a risk of having any type of kidney surgery, so your physician has to weight the risk of the actual surgery to the benefit of removing it. In most cases, the risk of surgery is greater.
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.
Thanks,
Kevin, M.D.
1) A kidney mass may be possible for your symptoms, but this should have been seen during the CT scans and MRIs you have received.
2) That is unlikely - and any lesion that is large enough to cause discomfort should be readily apparent on the imaging studies you have received.
3) If the imaging studies (i.e. MRIs and CT scans) are truly negative, then it is unlikely that such a symptommatic mass is present. Another opinion (preferably in a larger academic medical center) is always an option if the tests continue to be non-revealing.
4) Simple cysts are common anatomical abnormalities that are present in up to 30% of older adults. In most cases, they do not progress to cancer. There is a risk of having any type of kidney surgery, so your physician has to weight the risk of the actual surgery to the benefit of removing it. In most cases, the risk of surgery is greater.
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.
Thanks,
Kevin, M.D.
Member Comments
by Mossie, Apr 09, 2004 12:00AM
To: Kidney
0
by Jesse777, May 28, 2004 12:00AM
To: Kidney
0
by ladydi101, Aug 09, 2008 07:58PM
A related discussion, kidney mass was started.
by ann_11, Sep 19, 2008 12:49AM
A related discussion, why is my husband having tremors and sweating after his nephrectomy a month ago was started.
by ann_11, Sep 21, 2008 12:01AM
A related discussion, How long does it take to recover? was started.
