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Have history of left renal cancer and lower pole removed. On dialisis. What does this mean?

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Internal Medicine Specialist
Practicing since : 2000
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My father-in-law is 84 year old with a history of left renal cancer, lower pole removed. Now there is a 12.5mm right lower pole exophytic lesion with density of 26 HU. The density of this lesion increases to 53 hounsfield units of the arterial phase and 120 HU on the portal venous phase. What does this mean. He also has a 5.2 cm abdoninal aortic aneurysm, which has increased in size from 4.75 cm since July of this year. He is currently on dialisis. What does this all mean?
Posted Thu, 11 Oct 2012 in Cancer
Answered by Dr. Sudhir 4 hours later

These details point more towards cancer recurrence.These increase in HU values after contrast means this lesion is taking up significant contrast.Though not specific but this is one of the common feature of cancerous lesion.

At 84 years of age I guess his aneurysm needs conservative treatment.Controlling his blood pressure if he has it would be the desired treatment. At his age he might not be fit for aneurysm surgery.

Ideal next step would be to see oncologist. Oncologist might suggest a biopsy or follow up CT scan after 3 months to see if the lesion increases in size.

Please ask if there are doubts.Regards.

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