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What Do These Following CT Scan Findings Indicate?
Question: I am 46 female.
5"2 115 lbs
Prior smoker 1 pack /day for 14 years
Quit 18 years ago.
Otherwise healthy
No prior surgery
March 2016 Ct scan chest for unrelated purposes revieled a 4 mm noncalcified nodule in the left upper lobe.
Rec follow up was instructed at 12 months.
I have had bone pain in my left lower leg ( tibia) which started sept 2016 so I requested another ct scan at ten months because I feared the nodule metastised.
Repeat chest CT scan
1/3/17 ( 10 months from previous)
Nodule " remained stable"
There is a .09 cm pretracheal node slightly increased from last.
1)What is the chances that this 4 mm nodule is a cancer if it remained stable?
2) if it were a cancer, could a small 4 mm nodule metastises?
3) if yes, would it metasisize to the tibia?
4) should I continue to monitor the nodule with repeat ct scan or stop now , since it is stable. and if so, when and for how long?
Now to the leg ..
Sept 2016
Pain started as dull in tibia and sometimes sharp toward knee.
Shinbone feels bruised at times.
9/23/16 leg X-ray - normal
11:23/16 leg MRI without contrast showed proximal tibia stress changes without fracture and without a vascular necrosis
11/27/16 Ct scan of leg from knee to ankle was normal
1/3/17 another X-ray normal
I do not run or jog. I walk once in awhile but nothing strenuous.
1) what could the stress changes indicate?
2) Are stress changes in MRI the same as bone edema and pereosteal edema?
3) what role does that have to do with cancer?
4) would the abovectrsts absolutely rule out cancer/ metastasis ?
I guess I am concerned that this lung nodule , at 4mm spread to the bone.
Thank you
5"2 115 lbs
Prior smoker 1 pack /day for 14 years
Quit 18 years ago.
Otherwise healthy
No prior surgery
March 2016 Ct scan chest for unrelated purposes revieled a 4 mm noncalcified nodule in the left upper lobe.
Rec follow up was instructed at 12 months.
I have had bone pain in my left lower leg ( tibia) which started sept 2016 so I requested another ct scan at ten months because I feared the nodule metastised.
Repeat chest CT scan
1/3/17 ( 10 months from previous)
Nodule " remained stable"
There is a .09 cm pretracheal node slightly increased from last.
1)What is the chances that this 4 mm nodule is a cancer if it remained stable?
2) if it were a cancer, could a small 4 mm nodule metastises?
3) if yes, would it metasisize to the tibia?
4) should I continue to monitor the nodule with repeat ct scan or stop now , since it is stable. and if so, when and for how long?
Now to the leg ..
Sept 2016
Pain started as dull in tibia and sometimes sharp toward knee.
Shinbone feels bruised at times.
9/23/16 leg X-ray - normal
11:23/16 leg MRI without contrast showed proximal tibia stress changes without fracture and without a vascular necrosis
11/27/16 Ct scan of leg from knee to ankle was normal
1/3/17 another X-ray normal
I do not run or jog. I walk once in awhile but nothing strenuous.
1) what could the stress changes indicate?
2) Are stress changes in MRI the same as bone edema and pereosteal edema?
3) what role does that have to do with cancer?
4) would the abovectrsts absolutely rule out cancer/ metastasis ?
I guess I am concerned that this lung nodule , at 4mm spread to the bone.
Thank you
Brief Answer:
Hello dear. The chances of cancer are very low.
Detailed Answer:
Hello dear. I have gone through the details. I understand your concern. So with a 4mm nodule, we advise a repeat ct scan after 1year and if it remains stable, no further evaluation is warranted. For the same reason as it is stable, the chances of it being cancerous are practically nil. Even if it turn out to br a cancer, it will be having a very very low metastatic potential and it will initially grow locally rather than throwing mets. Even if somehow it throws mets, i have not seen a mets as distant as upto tibia. So you need not to worry.
Truly speaking i donot know about what actually is a stress change of tibia as it is not my speciality, but for sure stress change has no relation with XXXXXXX sort of cancer.
I hope you understand now.
Thanks and regards
Hello dear. The chances of cancer are very low.
Detailed Answer:
Hello dear. I have gone through the details. I understand your concern. So with a 4mm nodule, we advise a repeat ct scan after 1year and if it remains stable, no further evaluation is warranted. For the same reason as it is stable, the chances of it being cancerous are practically nil. Even if it turn out to br a cancer, it will be having a very very low metastatic potential and it will initially grow locally rather than throwing mets. Even if somehow it throws mets, i have not seen a mets as distant as upto tibia. So you need not to worry.
Truly speaking i donot know about what actually is a stress change of tibia as it is not my speciality, but for sure stress change has no relation with XXXXXXX sort of cancer.
I hope you understand now.
Thanks and regards
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thank you for your detailed answer.
So i had already followup CT scan after 10 months. Should i have another CT scan in future?
Pulnonology Dr on this site told me that 4 mm can metastisise and also can spread to tibia. I hope its very very rare!
You are cancer Dr.
Do you wirk with CT scan and MRI?
Would MRI or CT reviel a metasisis?
Does bone marrow edema ( stress changes) indicate cancer?
Thank you!
So i had already followup CT scan after 10 months. Should i have another CT scan in future?
Pulnonology Dr on this site told me that 4 mm can metastisise and also can spread to tibia. I hope its very very rare!
You are cancer Dr.
Do you wirk with CT scan and MRI?
Would MRI or CT reviel a metasisis?
Does bone marrow edema ( stress changes) indicate cancer?
Thank you!
Brief Answer:
Hello dear. No need for further ct scan
Detailed Answer:
Hello dear. So if a 10 mth ct scan is normal, no need to undergo further scans. As i told you a 4 mm nodule even if somehow rarely turns malignant, it will first grow locally rather than throwing mets. I have not seen a single patient with lung caner showing a tibia mets( there are more nearer bones and organs for mets rather than going to tibia)
I am an oncologist and i just read mri and ct. I donot work with them. But for sure, stress changes have nothing to do with metastasis. Rest assured.
You do not require an further workup.
Hello dear. No need for further ct scan
Detailed Answer:
Hello dear. So if a 10 mth ct scan is normal, no need to undergo further scans. As i told you a 4 mm nodule even if somehow rarely turns malignant, it will first grow locally rather than throwing mets. I have not seen a single patient with lung caner showing a tibia mets( there are more nearer bones and organs for mets rather than going to tibia)
I am an oncologist and i just read mri and ct. I donot work with them. But for sure, stress changes have nothing to do with metastasis. Rest assured.
You do not require an further workup.
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Above answer was peer-reviewed by :
Dr. Nagamani Ng
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