6mm nodule in pleura

@janar, it looks like you already found the request an appointment form for Mayo Clinic here: http://mayocl.in/1mtmR63

During the submission process, you will be asked if you live outside the US. The next step will be a telephone appointment with a scheduler to find out more. You will be able to ask about cost and insurance coverage and other questions you may have. When you speak with the scheduler, please ask them about translations of medical records. Your English is obviously very good, but I wonder if medical institutions, including Mayo Clinic, might require medically certified translations.

Every year, patients from more than 150 countries travel to Mayo Clinic for care. Here is more information about International Patient Services at Mayo https://www.mayoclinic.org/departments-centers/international

Oh no. Ive done so much work. Theres also so many pages. I don't really think all of it is that relevant, especially considering a lot of the CT imaging statements are unremarkable.

Is it enough if I have the latest patient report? Its the summary of my treatment and latest status.

Please confirm with the Mayo Clinic scheduler when you speak with them what is required from your past records, imaging, etc.

Great news. The CEA value has dropped to 5,2 ug/L now. It was 8,7 a week ago. Now that I wrote it here thats quite sharp drop. 40% drop. Wow that makes feel great. I mean its still elevated but it has dropped so much. I read from scientific studies that its half life in body varies from 4 to 25 days but is typically 7-15 days. So if this is true my CEA half life is like 9-10 days. I wonder what the peak value was..

Thats such a load off of my mind. I mean the nodule is probably still in my chest but that kind of drop should mean it shouldn't be anything that will kill me. Not just now anyway.

Still I send some forms to Mayo. I'm waiting for their reply about the translations.

I got my hands on my CT scans.

Now I'm not a radiologist, but... To me it looks like the nodule has been the same size since 2022. Largest size of it varies between 0-6mm depending on whether or not the CT slice hits it. The usual slice thickness I have been taken with has been 3mm but I had more precise imaging in 2022 because they were astonished of the finding in my nut. In 2022 the slice thickness was 0,6mm.

When I reconstructed it from first imaging simply by drawing it segment by segment it looks almost like a scar to me. I've never had CT taken before so for all I know it could've been there for as long as I've lived. I don't remember being stabbed though..

The length of it vertically is 7-8 segments, that is 4,2 to 4,8mm. Its like 4,3 mm wide at base, triangular in shape. Going from top to bottom the first image is less than 1mm in depth and maybe 2mm wide, second one it jumps to 4,3mm in depth and 4,2mm width, continues at 3,8mm depth and 4mm width, tapers off to D:3,5mm W:4mm, D:2,6mm W:3,7mm, D:1,66mm W:3mm, D:0,5mm W:1mm and then its gone. These layers are 0,6mm apart from the next one.

It's between my collarbone and my right nipple, just above and next to my third rib from top.

Of course later images its hit or miss can you even measure it. 3mm slice can miss it almost completely. It's pretty weird that it took them this long to start paying attention to it. Why did they even take so accurate CT if they don't even look at it. Makes me think that either my radiologists are not really paying attention or they are looking at something completely different that my savage cave-man eyes cannot recognize.

Seeing it somehow makes me feel more at ease. Sure. It's something in my chest but at least to my eye it seems to have stayed pretty much the same size. At most it has grown maybe 1-2mm over two years, no way 4mm. Radiologists must be smoking something. Maybe they are looking at something completely different. Thanks to the 3mm slice they have chosen to go with, it's impossible to say anything about it in my opinion. In some scans you can barely even see it because it falls just in between the slices. Like for example you can see it pretty clearly and obviously in 10/7/2022, then you cant even find it in 10/20/2022.

Sheesh.. I guess the CT slices cost money or something.

You bring up some good points. I’ve had the size of some nodules vary up and down in CT scans and that may be the CT view or a different radiologist. I’ve had that with ongoing lung nodules and a 20 year old kidney stone. I was told last year I had a pancreatic cyst show up on the CT (uh oh) so I had a special type of pancreatic MRI and oops, it was just fat. When I had my first abdominal CT 25 years ago, a liver cyst was an incidental finding. Sounded scary. I was told they are common and often congenital (there at birth). It has never been an issue. Year after year radiologists disagree on what the last one saw. My mother was told she had an aortic aneurysm for years and she thought she was going to drop dead any moment. 5 years later, oops it wasn’t an aneurysm. On and on I could go. I hope yours turns out to be congenital or an oops it’s nothing. The medical field is definitely not an exact science. Lots of educated guessing is involved.

I went through the images again and I got worried, extremely worried, because it seems like it has grown. I don't think quite as much as the radiologists say but it has grown after all. Of course there is a chance that the CT just so has happened to have taken picture in sequence so that looks like it has grown, but I'm skeptical. The length from base/pleura has been following:

1/3/2023 3.84
5/4/2023 3.95
8/22/2023 3.58
11/27/2023 4.35
2/27/2024 5.28
5/24/2024 5.65

Does anyone know how radiologists measure nodules? I read that it is the average of largest length and width. Width is measured perpendicularly to length.

Furthermore I read about tumors of pleura not being resectable, which made me fall off the edge again. Only reassuring thing is that whatever it is, it looks very much like the triangular one in this study:
"Management of Nodules Attached to the Costal Pleura at Low-Dose CT Screening for Lung Cancer"

You'll probably find it if you google it.

Reassuring part is that the study says all triangular nodules were benign. As in 0 were malignant in a study of ~900 participants. My nodule is almost in the same spot as mine is. Mine is just above the third rib from the top, right side. Of course it shifts as I breathe but with my lungs full of air its about 2-2.5mm left of my nipple and about 4cm upwards. So not quite where my doctors initially told it was (close to sternum).

I decided not to go get my CEA measured again. I don't think it would change anything even if it had gone up again. Only thing it could do to me is make me more worried. I've been in shambles past month. Last two days were much more reassuring but today after I went looking at the images again I got worried again.

Although Mayo Clinic accepts self-translated texts, I decided to buy a translation. Hopefully it will be better quality than my own texts. I should get it by next tuesday so I can send it to Mayo. The Mayo staff has been incredibly pleasant so far.

Because I have over 50 lung tumors scattered across both lungs, resection is not a viable option. They fried the largest one 2.6 cm with microwave ablation. 2 hour non-surgical but invasive procedure. An interventional radiologist inserted 2 probes through my back and lung into the tumor using repeated CTs to guide placement. Accurate placement is the challenge. Once placed, it took about 20 min to fry the tumor. That was 3 years ago. Success. They will do the same to any others that start to grow faster than the rest or reach 2 cm as they are more likely to metastasize. So, maybe there are alternatives to surgery for you as well. Hope so. Imagine how disheartening it was to hear I had 50+ lung tumors. I was 49. I understand your stress about this. That was 16 years ago and I am enjoying watching the squirrels play in my patio on a sunny day today. You’re doing a great job pursuing answers and treatment. Stay hopeful.

Wow 16 years ago. I've never even heard of such treatment. And it managed to stop all your tumors! I feel envious of your treatment.

It gives me hope but also makes me a bit sad because I'm not sure they even give that treatment in Finland.

It only destroyed the one tumor. Tumors will have to be destroyed one by one as needed but only when needed. I also take octreotide injections to manage symptoms and slow growth even more. Luckily they are very slow growing typical carcinoids which is neuroendocrine cancer. It’s rare, only 1% of lung cancer cases but luckily treatable. Hoping whatever yours is will be treatable as well. Yours seems slow growing as well. My treatment is by a university hospital. I’m sure Mayo would do this procedure if appropriate for your case.