C-File Not Complete

[63SIERRA]

I requested a copy of my c-file several months after rating for kidney removal due to kidney cancer . there was nothing in my c-file at all abt my kidney surgery. why would this be ? the files were in my med recs at the local vamc, which I have copies of.

[free_spirit_etc]

The study also said that 2 cases in their study had been misdiagnosed as simple renal cysts.

It also says "It is now generally recognized that localized renal cancers are best treated by nephron-sparing surgery (partial nephrectomy). As long as the resection margin of the tumor is negative, partial nephrectomy is sufficient to avoid local recurrence. "

So, the standard of care -- at least in 2013 -- it to try to preserve as much of the kidney as they can. But that might not have been the case in 2003. The study said the patients that received the kidney sparing surgeries were all after 2008. So it is possible that they used to remove the whole kidney, but now try not to unless they have to.

" Partial nephrectomy began to be widely performed for renal carcinoma at our center since 2008. In the present study, most of the nine patients undergoing radical nephrectomy were admitted before 2008 and had large renal mass. The four cases receiving partial nephrectomy were admitted after 2008 and had T1 stage."

Edited November 12, 2013 by free_spirit_etc

[free_spirit_etc]

This shows why it didn't grow that fast in 8 years. They have very slow growth. I know to you the growth seemed big. But it seemed to be pretty slow growth to me for an eight year passage of time.

The good news is that this type of cancer doesn't metastasize easily, and has a low recurrence rate.

http://www.bioportfolio.com/resources/pmarticle/480454/Cystic-renal-cell-carcinomas-do-they-grow-metastasize-or-recur.html

CONCLUSION. Cystic RCCs exhibit slow indolent growth, if any, and show no significant metastatic or recurrence potential, with excellent clinical outcomes. We raise the need for revisiting current imaging protocols that may involve frequent pre-and posttreatment imaging in cystic RCCs.

​There are also three different sub-types of cystic renal cell carcinoma.

RESULTS. Of 47 tumors, 27 (57.5%) were clear cell RCCs, 12 (25.5%) were multilocular RCCs, and eight (17%) were papillary cystic RCCs.

Edited November 12, 2013 by free_spirit_etc

[63SIERRA]

That is some excellent information and your efforts are appreciated, thank u.!

I recall the doctor telling me that the type cancer I had was quite common, im going to do some research. if I recall it

was renal cell carcinoma type 1 or type 2.

I will post the radiologist report and see if we can decipher it.

Edited November 12, 2013 by 63SIERRA

[63SIERRA]

Here is the report in end of aug 2011 before kidney nephrectomy in oct 2011

reprt ' ct scan of abdomen and pelvis

clinical history . assess patient with solid renal lesion

technique : abdomen is initially imaged without iv contrast, abdomen and pelvis are then imaged after administration of intravenous contrast.

findings.

Heterogeneously enhancing lobulated soft tissue mass in the upper pole of the right kidney measures abt 7.0 X 6.0 X 5.6 centimenters in the maximum dimemsions. It has few peripheral calcifications . It is highly suspicious for a renal neoplasm like renal cell cancer. There is loss of fat planes between the liver and two superior lobu.les of this mass.

This mass extends into the renal hilum of the upper pole. Right renal vein size is mildly prominent as compared to the contralateral side but doubt the presence of any thrombus within it. It enhances uniformly.

no mass involving left kidney.

Subtle focal , hypodene lesion in the posterior segment of the right hepatic lobe , measureing abt 1.5 cm . It is not compatible with a cyst or a hemangioma on this study. would suggest further evaluation with mri examination.

Two small lymph nodes are present superior to the portal vein. the larger measures abt 2.2 X 2 cm. A few scattered retroperitoneal lymph nodes are present in the left para-aortic, and aortocaval region . Scattered subcentimemter mesenteric lymph nodes also present . These are not pathologically enlarged.

Both adrenal glands are within normal limits. No evidence of abnormal sized lymphadenopathy within the abdomen. Both the imaged lung bases are clear and clear of any nodules . Spleen do not reveal any focal lesion. Portal vein is patent. The pancreas

is within normal limits.

ct scan of the pelvis

Appendix is visualized and is within normal limits. A small calcified nodule in the pelvic mesentery adjacent to the sigmoid is indeterminite. could possibly present a calcified lymph node. It does not demonstrate any communication with the sigmoid colon .

Sigmoid and descending colon diverticula are present without any changes of diverticulitis.

There is bilateral spondylolysis at l4 vertibre.

impression/

Right renal mass highly suspicious for a renal neoplasm like renal cell cancer. Please refer to the body of the report for all the details.

in particular , its maximum dimension is abt 7 cm, it extends into the renal hilum and 2 of its superior most lobules have loss of fat planes with the liver.

[63SIERRA]

it really sounds to me like the " lobulated soft tissue mass' is the cyst they refered to in 2003, and it is what became cancerous, and then extended into the kidney.

[63SIERRA]

now keep in mind, I knew nothing at all abt this, until the ultrasound in 2011, when the ultrasound tech noticed it. evidently even she could see something was not right, with the untrasound.

now does it seem odd that the ultrasound girl, " refound it incedentally " and it then became big news, urgent , life and death situation? what if she had not noticed it? what red flags would have gone up, to signal my primary care doc?

The ultrasound was for my liver, not my kidney.

also what is odd is the doctors are always quick to ask, how did they find it?

they never say hmm. I see in your records they found a cyst on that kidney, in 2003. they never mention that.

almost like they are probing me to see what I know.

wait till they ask me again.

Edited November 12, 2013 by 63SIERRA