spine cyst

[bucky107]

I had back pain when they did an x-ray they found a large 7cm cyst on my left kidney the local urologist said it was nothing to worry about..however i had a mri and ct...they found a cyst on t-12-L-1 I also had disc bulge at L-4,5 and C-5--6 .The renal cyst was found in April of 07..removed sept 07  I was sent to therapy but it anly made my pain worse finally i insisted on a second opinion the urologist at dartmouthhitchcock took on look and said it should be removed the cyst turned out to have a tumor inside that tested positive for renal cell carcinoma..my back pain has become almost unberable and my doctor wants me to try a pain clinic..i feel that i'm getting the same run around on my spine cyst that i had on my kidney ..my last mri showed the spine cyst has grown about i cm in the last year it is now 2.6x1.6x1.6  there is scalloping and enlargmentof the spinal canal also nerve root compromise cannot be excluded.
Would you think my back pain could be caused by this cyst also with the history of cancer do you think it could also contain cancer cells as my kidney cyst showed no signs until it was removed, tested..thank you for your time john          

[Craig Brooker]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history I can not comment on the reason for your back pain directly.  But given your history of Renal cell carcinoma, it would be important to follow up with an oncologist to make sure you don't have metastases (remote cancerous tumors) if this hasn't been done already.  It would obviously be important to bring imaging of your current cyst and certainly worthwhile to ask the questions you have above.  They may want to do further work up including possibly further imaging with contrast if this hasn't been done already.  

Cyst aside, the reason for you pain may be able to be further distinguished based on it's location, whether it radiates somewhere else, the duration, the course (e.g. if it's getting better or worse), if you had any other trauma, etc.  These items may be helpful in localizing the cause of your pain and possible it's treatment.  I hope this is helpful.

[t_carter]

My son is a c5/6 quad since an accident that occured in 2001.  From that time until May of this year he has steadily increased in strength and mobility due to physical rehabilitation at Shepherd Center, Atlanta, then to St. Louis, Washington University with Dr. McDonald and his group and then in 2003 we moved to San Diego, California where he has been at Project Walk in Carlsbad, CA. doing physical therapy 3-hours a day, 3 days a week.  However, in May he began to have blood pressure issues (low blood pressure) passing out and weakness, he was hospitalized because we thought he had food poisioning and they took all kinds of test from a gastroenterology to urology to cardiology and could find nothing except an ilius, not a bad one, a slowing of the cartiroid arteries, nothing major they just put him on Asprin and a .05 mg fludrocortisone for the blood pressue.  However he is not getting better and continues to feel weaker at workouts and can only do about 1 hour before feeling fainty and has to pee alot.  He has to cath about every 3 hours at night and has started getting dysreflectic (sweating and stuff) at night when he lays down.  We finally got an appointment with a neurologist and he saw him last week.  He had not seen a neurologist since 2003 when we came to California.  The neurologist suggested an MRI and and x-ray to see if he has a cyst or tethering of the spinal cord in the area of his injury.  My question is, if he does and this is the reason for all of the current symptoms where is the best place in the country to have surgery or something done concerning this and is anyone doing anything beyond removing the cyst fluid or untethering that we might be interested in that may cause him not only to get back to where he was but possibly progress even further.  Is anyone using stem cell surgery in this country are there any clinical trials going on? I would also like to know if this is a risky surgery should he need it and do you think we should seek several opinions.

the nightmare continues.
kindest regards
Tammy Carter

[jawsUK]

Hi Bucky (John?)

I had a spinal MRI scan 18 months ago and several 'peri-neural' or Tarlov cysts were identified.  One was described as large (several centimetres) and it even goes outside the perimeter of the scan, so has been incompletely imaged.  These cysts are in the sacral area and I believe may be the reason I am now getting neurological problems - they are probably affecting nerve roots etc.  Many of us are apparently born with these, but unless we have an MRI scan, they often remain there 'silently' and without problem.  Most are asymptomatic.

I am not a doctor, but thought this might be helpful for you to know.  By coincidence, when I was a teenager, my father had a huge cancerous tumour at the base of his spine.  I believe that these are extremely rare.  His had grown to such a size that it eventually enveloped all the nerves there. Before I go any further on this story, I want you to know that he is now in his late sixties and is fit and well!  (Despite having had to learn to walk again after several operations to remove the tumour).

I would have thought that the scan would show the difference between what are believed to be relatively harmless (though this is debatable) Tarlov cysts like mine (which are filled with CSF I understand) and other types of cyst (eg cancer).  I did tell the orthopaedic clinic that gave me my scan results about my family history of spinal cancer, and they absolutely assured me that they could see from the scan that mine are not cancerous cysts. (All I had done was an MRI, so as I say, they must be able to tell from that).

What I would say though, is that for years, my Father had been complaining of back pain (he is unbelievably brave and did not make a huge fuss), but was 'fobbed off' by his GP several times.  His symptoms were not taken seriously and no scan or tests were ever done. The tumour grew over several years.  It was not until Christmas Day 1980 when he woke up in indescribable pain, and an inability to move his legs at all, that the cancer was finally diagnosed.

Do not feel that you are 'making a fuss' by pursuing this (you have a good excuse to do so after the renal tumour), but because of what they can see on MRI scans, it sounds very hopeful that these have been 'interpreted' as safe and that you will be okay.  Perhaps you have Tarlov cysts like me?  They are quite common I understand.

Best wishes and good luck!

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