Discrepancy in size of tumor

Was there a biopsy done on the tumor before your kidney was removed?

A biopsy on a kidney tumor is often not possible because of bowel, & bones being in the way.

A CT Urogram is to show the function of the urinary tract. Which means it isn’t the most detailed image of the anatomy (larger slices through). The pathologist has the advantage of discerning the cell layers of the tumor. Meaning, fat (possibly surrounding tumor), fluid, and normal cells, vs actual tumor cells. That is part of the reason a “tumor” is called a “mass” on imaging. Only by removing & dissecting it, can they truly tell the difference. The surgeon is going by vision. The size matters much less than the fact that it’s benign, & not spread. All are good news!

I had kidney removed in January of this year and no biopsy was done. I went to three specialists and they each said the same thing. Over 20% of biopsies done on kidneys say there is no cancer, when indeed it is cancer. When my kidney was evaluated after removal, pathology report found it was a non cancerous tumor of 4cm. Prior to surgery I had scans to see if cancer had spread. Every test was negative, however the treatment of choice was a total nephrectomy. We try to inform ourselves the best we can and make the best decision we can. Blessings.

Thank you for following up on my question. What a difficult decision you had to make! You certainly were a good advocate for your own health, I’m glad it wasn’t cancer but so sorry that you lost your kidney.
Blessings to you too.

Kidney masses, particularly small ones, are funny things. Worrisome and usually benign, deciding what to do and when to do it is almost never clear. Active surveillance is often used to monitor. I had a small mass kidney mass show up pre chemo for breast cancer. It has been followed for 6 years with scans. About 2 years ago its appearance got “bumpy” so a little more concern. One year later scan showed no mass at all. Another scan in a year will happen.

No, I didn't have any risk factors for a malignancy, so I wasn't too concerned about that, but the doctor advised the surgery concluding, following the laparoscopies, that the mass was larger than the CT Urogram indicated and was taking up 1/3 of the kidney. As Amyb5 states below, there are reasons for not doing a biopsy before surgery. A think a concern with seeding, i.e.. spreading cancerous cells is another reason.

It seems every situation involving these "masses" is a little different and it is hard to know if we're making the right choice. The surgeon seemed so sure the kidney had to go and I had to agree when I saw the scan picture. It was quite a shock to get that pathology report. I am relieved to know it was not malignant and thankful that God gave me the spare, Praying your mass stays gone! God bless you.

I know exactly how difficult your decision was dealing with that level of processing for almost 5 years. The best case scenario for me, before it disappeared completely, was that often they felt it was simply scar tissue from an initial mass that they bladed between chemotherapy and radiation. Again that biopsy Did not determine any malignancy at all. I’m glad that at least the last scan disappeared, that’s a mixed blessing as well. Scar tissue, a really benign condition, doesn’t just disappear so the best case scenario of scar tissue has gone away. I’m able to access Medical information readily and it seems that around 2% of masses like this on kidneys will “disappear “from a scan at some point, sometimes they return sometimes they don’t. I know with each scan I had when I would talk to the urologist we would have the discussion about , should it be removed or should it continue to be watched and because the size of mine about the same and remained really small we always opted for let it be. When it started to change, it didn’t get any bigger, but it started to look like a bubbled up mass that was worrisome. The crazy thing just vanished last year! I have another scan in about six months and we’ll see what it looks like. But there’s no easy answer and there’s no 100% accuracy with any biopsy report. What seemed maybe the most definitive bit of information for me was that I had absolutely no symptoms of kidney disease or kidney issues. my kidney function was and remains perfectly normal. I have no symptoms at all. What I have learned is that those kidney masses can just drive you nuts. Everyone patients and doctors included, do the very best they can to make the very best judgment call. I hope your stay gone forever!

Thanks for your input. It is reassuring to know that there is no definitive answer to this and I can't blame myself for going with the nephrectomy or agonize over whether or not there was some action I should/could have taken that would have saved my kidney. We do the best we can with the info and advice we have and leave the rest to God.