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Lab report showing renal mass due to hydroureteronephrosis, renal enlargement and lymphadenopathy. Suggestive of hepatic metastasis

Hi Doctors,
My dad result from his lab exams, impression/solid left renal mass suggestive of neoplastic process with secondary mild to moderate left hydroureteronephrosis, non specific right renal enlargement, right suprarenal solid mas suggestive of adrenal neoplasm presumably metastatic..paraaortic and peripancreatic lymphadenopathy.. nodal metastasis is considered, right hipatic lobe solid nodule suggestive of hepatic metastasis.. cholecystolithiasis. Here is no evidence of biliary ductal obstruction, grade 1 prostatic dad is in the philippines and my sister just texted me the result, what is this all about? Are these curable? Thanks from Canada
Asked On : Mon, 15 Apr 2013
Answers:  2 Views:  31
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General Surgeon 's  Response
Apr 2013
Hi and welcome to HCM.
Unfortunately this sounds very serious. This is expanded malignant disease and prognosis and treatment are hard to predict, but I cant tell details without more info.
It is always possible that all these masses and changes are benign, but CT scan is usually accurate about this and this looks like primary kindey cancer with multiple metastasis. This is hardly curable,almost impossible. First the surgical procedure should be performed and then chemo or radiotherapy or both. All in all long and difficult treatment is neccessary,but I hope that everything can still be well controled.
Wish you good health.
Answered: Thu, 18 Apr 2013
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Internal Medicine Specialist Dr. Omer's  Response
Patients with renal cell carcinoma (RCC) can present with a range of symptoms due to the tumor itself (eg, mass, pain), invasion of the urinary tract (eg, hematuria), paraneoplastic syndromes, or the presence of metastases. In addition, RCC is more frequently being diagnosed incidentally as a consequence of increased use of imaging procedures for other reasons. signs, or other findings suggestive of RCC should undergo evaluation for the presence of a renal mass. Ultrasound and CT can confirm the presence of a mass, distinguish RCC from a benign cyst, and assess the extent of disease.
Even in the absence of abnormalities suggesting malignancy, imaging studies cannot reliably distinguish a benign renal tumor from an RCC. Thus it is generally recommended that lesions other than simple cysts be resected.
The TNM staging system, which is based upon the extent of the primary tumor and the presence or absence of regional lymph node involvement or distant metastases, is preferred (table 2). This staging system correlates with prognosis, and provides important information for patient management.
Individuals thought to be at increased risk for the development of RCC should be considered for routine screening with abdominal ultrasound, CT, or MRI.
For patients presenting with renal cell carcinoma (RCC), the tumor node metastasis staging system provides the primary prognostic information
For patients with metastatic (stage IV) disease, multiple clinical parameters have been identified that are associated with prognosis. These include a poor performance status, an elevated serum lactic dehydrogenase (LDH), and elevated serum calcium, anemia, and the presence of metastatic disease at the initial presentation.
Answered: Wed, 17 Apr 2013
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