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What Do These CT Angiography And CT Lower Abdomen Reports Indicate?

Posted on Wed, 29 Jul 2015

Question: My father 54 years age ct angiography and ct lower abdomen shows a report that " I'll marginated partially enhancing Sol in lower retroperitoneum common illiac region enhancing proximal IVC and biolateral common illiac vessels dampened contrast flow within bilateral common and external illiac Veins area of poor enhancement and apparent filing defect within left external illiac vein (possibility of Venus thrombus can not be exclude) artarial contrast run of preserved

Both the ureters seen adherents to lower retroperitoneal illiac mass with resultant hydronephrosis hydroureter(proximal) showing delayed contrast excretion

Few discrete mesenteric nodes .
what does it mean ?is it a cancer ? Is there any treatment for it ?

Answered by Dr. Rakesh Madhyastha (38 minutes later)

Brief Answer:
Urgent surgical intervention required

Detailed Answer:
Hello

Thanks for the query

The report is suggestive of cancer which is pressing on the ureter ( pipe connecting kidney and the bladder ). There is also blockage in the major Veins which is important for the legs.
Here is what I suggest

1. MRI of the abdomen with contrast has to be done to know how big the tumour mass is
2. I strongly suggest that surgical oncologist is approached so that this mass can be removed and sent for historpathology to see if it cancerous or benign
3. any further delay can lead to it becoming bigger and inoperable
4. If a surgical oncologist is not available then please approach a general surgeon at least

I hope I was of help, if you have any further queries please get back to me

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (26 minutes later)

If it is a cancer then is it cureable ?? Is there any treatment ? He will survive ?? What are the best treatment for this ?
If it is not cancer than what is it ?
Doctor is telling that blood cloted on the area
Is it the delayed stage ??
His one leg is also swelling

Answered by Dr. Rakesh Madhyastha (1 hour later)

Brief Answer:
Unknown mass

Detailed Answer:
Hello

Thanks for getting back. I understand how stressed you might be right now.

1. It could be cancer, only after removing the mass and sending for test we will get to know if it is cancer or not
2. If it is not cancer then it could be just a benign growth which can be removed and rest assured it won't spread
3. The veins are blocked most likely because of the mass, it will require anticoagulants like low molecular weight heparin or acitrom

Could you please let me know what your doctors have planned?

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (16 hours later)

The doctor already prescribed acitrom.he is telling that after 15 days of taking his medicine he will refer us to a surgeon for biopsy.
he is telling that operation may not be possible
please tell me that operation is possible or not if not than what will be the treatment

please give me some idea that how the biopsy can be done ? what will be the procedure.

please tell me that if it is a cancer then what is the treatment for it? is operation possible on that place.

please guide me about the waste case what will happen he will survive or not.

Answered by Dr. Rakesh Madhyastha (5 hours later)

Brief Answer:
CT guided biopsy

Detailed Answer:
Hello

I am not sure why it is not operable, but defintely one can attempt a CT guided biopsy. Please ask your doctor for a CT guided biopsy.

I must add here that one cannot operate when someone is on Acitrom as it makes the blood thin, he will require to stop taking the drug for a day before the operation

It is hard to tell without a biopsy whether it is cancer or not.

Was any MRI done? Could you please attach the MRI report as well?

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (2 days later)

Doctor I have asked so many onko sugeon and radiologist here they are telling this is a critical case and may be not opetable
They are telling that CT guided biopcy also may not be possible they ready for operation biopcy
Now you as a doctor please suggest me the best hospital for this treatment operation and biopcy
If any doctor you know who can do the biopcy please give me the contact.
Guide me the best hospital for this kind of rare opearation and biopcy

Answered by Dr. Rakesh Madhyastha (17 hours later)

Brief Answer:
Follow up

Detailed Answer:
Hello

Thanks for getting back

Dr Somshekar of Manipal Hospital, XXXXXXX is a very good onco surgeon. He is the most famous in our state. If you are ready to come down then probably I can get into contact with him. I dont know him personally but in our doctor community he is supposed to be good.

Regards

Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar