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Tuesday, March 11, 2014
Urinary Tract Cancers
What did I do wrong here?
First of all, I am a 33 year old female in excellent health. But, I have a situation that I am confused about.... A couple months ago I went to the ER for SEVERE left side pain. They thought I had a kidney stone so they did a CT scan. They sent me home telling me to follow up with my OBGYN because I had an upper UTI and an ovarian cyst. The next day my OBGYN did an ultra sound and told me he did not like the looks of my left ovary and ordered a CT scan with contrast for the following day. Later that day he called me to come into the office. He told me that my ovary was fine but my kidney had a lesion on it and the hospital was recommending more tests. I had an MRI done the next day. The following Monday my OBGYN`s office called me and told me that they wanted me to see an urologist and they were setting me up an appointment. They called me back a little later and told me they set it up for the next day and that I needed to go pick up my films from my CT scan and my MRI. At my urologist appoinment he told me it was a 2.5 cm tumor and that he beleived it was cancer. But, he was going to order an ultrasound just to make sure. The following week when I returned to see him with my ultrasound films he advised me that I needed a partial nephroectomy. I asked about doing a biopsy first and was told it wasn`t necessary. He scheduled my surgery for a couple weeks later. During my surgery he took my whole kidney instead of just part because he said the tumor was in my blood supply and he couldn`t get blood to the lower part of my kidney because of this. 3 days later... on the day I was to be discharged from the hospital... my urologist came in and told me I did not have cancer YEAH! But, then he proceeded to tell me that he had removed a healthy kidney... there was not a tumor in it, it had no signs of infection or scar tissue. He said he just didn`t know what they saw on the films but my kidney was perfectly healthy with no defects. How can that be? He took the whole kidney because the "tumor" was in my blood supply. Should have I been firm about wanting a biopsy? This would have shown no tumor. Where did I go wrong here? What could have I done to prevent this from happening? I am very confused right now!
When a tumor is suspected on CT, MRI and Ultrasound exams surgery is typically performed without the need for a biopsy. There are situations where there are changes noted on these studies and a tumor is not found, but this is unusual. Without viewing the studies it is difficult for me to comment but it sounds as if you had changes present that were not associated with a malignancy.
The question you ask is a reasonable one - did I need the surgery? From what you tell me the procedure seemed indicated but again a review of the study would be necessary to render a more definitive opinion.
Martin I Resnick, MD
Formerly, Professor of Urology
School of Medicine
Case Western Reserve University