Scan results
Short answer—the tumor has grown into the fat surrounding the kidney but has not yet invaded into surrounding tissue. A full radical nephrectomy will be performed.
After the CT with contrast on Thursday afternoon (4/17) the diagnostic radiologist wrote a report of his findings for Dr. Savage and his P.A. to discuss. The results and films were posted to mychart even before the care team had a chance to review them and talk to us so most of what I share right now was taken straight from that document and plopped into google so AI could explain it to me. The obvious news is that there is no evidence of metastatic disease in other organs. Specifically unremarkable are lungs, bones, liver, gallbladder, spleen, pancreas, adrenal glands, GI tract, lymph nodes, reproductive organs. Unremarkable may be my new favorite word. So while we have the official documents we will have to wait until this week to discuss the results officially with Dr. Savage.
April 19: We received a note from Dr. Savage around 7:30pm Saturday night after looking at the films he recommended removing the entire kidney. This was something he discussed at last week’s appointment. Because of Matthew’s age the goal is to try and save part of the kidney but honestly I don’t think either one of us really thought that was going to be an option. Hearing that he will officially lose the whole kidney is what we were anticipating but it still hit hard.
He also recommended performing an outpatient procedure to remove the kidney stone this Tuesday, April 22nd. We’ll already be at MUSC that day for a pre-op appointment.
CT Abdomen / Pelvis
5.4 cm right upper pole renal neoplasm with extension into the perirenal fat without perirenal fascial invasion. Right renal vein is patent. No evidence of metastasis or suspicious lymphadenopathy in the abdomen or pelvis. Incidental 3 mm right ureteral stone at the level of the right ureterovesicular junction. No hydroureteronephrosis.
This description indicates a kidney cancer (renal cell carcinoma) that has extended into the surrounding fat (perirenal fat) but not into the deeper layers of the kidney (perirenal fascia). The renal vein is open, and there's no evidence of metastasis or abnormal lymph nodes. This would likely be staged as T3aaccording to the AJCC TNM staging system for renal cell carcinoma. A T3a stage in the AJCC TNM staging system for renal cell carcinoma indicates the tumor has invaded the renal vein or its segmental branches, the pelvicalyceal system, or the perirenal and/or renal sinus fat, but not beyond Gerota's fascia. This means the cancer has spread beyond the kidney itself but has not invaded the adrenal gland or the tissue surrounding the kidney.
Here's a more detailed breakdown:
Renal Neoplasm: The presence of a tumor in the kidney.
Extension into Perirenal Fat: The tumor has grown beyond the kidney itself and into the fat surrounding it.
No Perirenal Fascia Invasion: The tumor has not penetrated the deeper layer of fat surrounding the kidney, which is considered the outer layer of the kidney (Gerota's fascia).
Patent Renal Vein: The renal vein is open and not obstructed by the tumor.
No Metastasis or Lymphadenopathy: There is no evidence of the cancer having spread to other parts of the body or to the lymph nodes in the abdomen or pelvis.
T3a Staging: Based on the findings, this would be classified as stage T3a, indicating a tumor that has extended into the perirenal fat but not beyond the perirenal fascia, or that has invaded the renal vein.
CT Chest
No evidence of metastatic disease within the thorax.
A CT Chest scan shows no evidence of metastatic disease within the chest. This means that the scan didn't detect any cancer cells that have spread to other parts of the chest from a primary tumor in the body.
What’s next
The surgical team will work on getting a date to remove the kidney laparoscopically in about 4-6 weeks.
April 22
Pre-op appointment with the anesthesiologist team to perform bloodwork and an EKG to be cleared for surgery.
Outpatient procedure to remove the kidney stone so that it doesn't pose a problem for kidney removal.
PRAYER REQUESTS
The tumor DOES NOT CONTINUE TO GROW AND DOES NOT EXTEND PAST GEROTA’S FASCIA.
The procedure for stone removal will offer some immediate pain relief.
A date for surgery is scheduled quickly so we can make a plan.
For Wells and Tagg to continue to feel loved and supported and know fully that everything will be ok.
