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Reevaluation of Renal Lesion After Extended Active Surveillance

7/19/2025, 6:01:01 PMMale25-34

My mother, aged 82 and weighing 145 pounds, remains in good health and leads an active lifestyle. We have recently encountered a significant update in her medical evaluation concerning a suspected renal cell carcinoma (RCC). Enclosed are screenshots from various scans alongside a comprehensive summary document detailing the findings and measurements, as well as the report from the newly consulted radiologist. **Recent Radiologist Analysis** The latest report states: "Due to the fluctuating size of the right renal lesion over time, along with observed blood presence on one non-contrast CT scan and a fluid level on at least one ultrasound, this lesion is most likely a hemorrhagic cyst. Furthermore, there are also indications of hemorrhagic cysts in the left kidney." I utilized a summary of findings I compiled to engage with ChatGPT, which assessed that the likelihood of the lesion being RCC is considerably high, rated at approximately 65 to 75%. **ChatGPT Analysis:** **Cystic Renal Cell Carcinoma (RCC): Likelihood - 65-75%** **Reasoning:** Key factors include an enhancing solid component, growth over intervals, notable cortical bump, increased complexity, and consistent size escalation (particularly from 2023 to 2025). Additionally, the Bosniak classification indicates features typical of **Bosniak III-IV**, suggesting a malignancy risk of 50-90%. What deeply worries me is that the latest radiologist's report altered measurements considerably from earlier assessments. The accompanying screenshots I possess corroborate the previous evaluations. **Note:** My earlier post was mistakenly deleted, prompting this new inquiry. Your support and insights on this matter would be invaluable.

Crohn's DiseaseThyroid DisordersInternal Medicine

Answers (1)

Cony

7/19/2025, 6:01:43 PM

OpenHealth AI

It sounds like you and your mother are facing a complex and concerning situation regarding her renal lesion. The recent evaluations suggest it could be a hemorrhagic cyst rather than renal cell carcinoma (RCC), which is important to consider and understand.

Main Points:

  1. Recent evaluations indicate that the lesion is likely a hemorrhagic cyst, not necessarily malignant.
  2. The previous assessments showing fluctuating sizes and other features raise valid concerns, but the current analysis presents a different perspective.
  3. Regular monitoring and clearly defined follow-up steps are essential in managing this issue.

Explanation:

Based on the radiologist's latest report, it seems they assessed the lesion as probably being a hemorrhagic cyst due to its size changes and presence of fluid. This is a type of cyst that contains blood and can sometimes mimic a more serious condition. The confusion arises because some characteristics could overlap with RCC; however, the current assessment shows a different interpretation that may alleviate some worries.

Next Steps:

  1. Monitor Symptoms: Keep a close watch on any changes in your mother's health or new symptoms. Note any signs like blood in urine, pain in her side, or changes in her overall health.
  2. Request a Second Opinion: Consider consulting another specialist, preferably a urologist with experience in renal conditions, for a further assessment. Comparing opinions can provide clarity and peace of mind.
  3. Follow-up Imaging: Discuss with the doctor the timeline for follow-up imaging, such as another ultrasound or CT scan, to reassess the lesion regularly. Staying proactive is key.
  4. Document Findings: Continue to document all findings, measurements, and changes noted in scans, alongside any symptoms your mother may experience. This can aid healthcare providers in making informed decisions.
  5. Communicate with Care Team: Maintain an open line of communication with her healthcare providers to discuss findings, interpretation of results, and any concerns you may have moving forward.

Stay positive and support your mother through this process. Understanding the situation can often alleviate some anxiety, and forming a solid plan will help in managing her health effectively. If you need additional details or have further questions, feel free to ask.

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