Renal Cyst

Posted by charlena @charlena, Mar 8, 2018

My husband has just been advised he has an 8mm renal cyst. The doctor advised "it is nothing to worry about right now". I don't agree with that. I welcome any and all comments from others with this condition. Thank you!

Hi @charlena,

Here's some information from Mayo Clinic:
https://www.mayoclinic.org/diseases-conditions/kidney-cysts/basics/definition/con-20035205

I’d like to invite @pkindron @rshardi @IWantToBelieve @trishanna @bonitav @upnorthnancy and our Mentor @rosemarya, to join this discussion, as I think they may have some related experiences with kidney cysts. You might also be interested in reading these discussions:
– CYST ON KIDNEYS https://connect.mayoclinic.org/discussion/cyst-on-kidneys/
– Can minimally complex kidney cysts become polycystic kidney disease? https://connect.mayoclinic.org/discussion/can-minimally-complex-kidney-cysts-become-polycystic-kidney-disease/

What symptoms did your husband have, @charlena, that led to his diagnosis?

@charlena, I wish that I had something to add, but I have had no experience with kidney cysts. I see that @kanaazpereira has already provided you with some good links for more information. These can be a good starting point for educating yourselves.

If I were you, I would have a face to face chat with your husband's doctor and find out what he means when he said, "It is nothing to worry about right now."
For example, Will it be a problem later? How will we know? Can we do anything to prevent it from becoming a problem?

What kind of symptoms did he have? and what kind of tests were performed to reach this conclusion?
Rosemary

Hi, @charlena. Sorry to hear of your concerns about your husband's renal cyst, and I hope you can find some comfort in my case, which Kanaaz Pereira provided in her link to it (https://connect.mayoclinic.org/discussion/cyst-on-kidneys/). A crucial question for me is: Where is the cyst located? Is it on the outside surface of the kidney itself? Or is it located on an adrenal gland that rests on the surface of the kidney? Or is it inside the kidney? I have no experience with an internal cyst, but my medical team has thoroughly studied my cyst on the surface of my kidney.

The location of the cyst can help answer two important basic questions: First, mine was NOT located on an adrenal gland where it could have been a rogue gland producing excess adrenal hormones that can drive up my blood pressure. Second, images of the cyst did NOT show it to be a growing tumor, which might have been cancerous — at least not yet, so we check it out every year during my annual physical exam. So far, so good.

My experience makes the case for having a kidney doctor (nephrologist) take the lead in diagnosis and treatment of high blood pressure, with the help of an endocrinologist to check out any hormones that might be driving up blood pressure. Leaving hypertension to cardiology alone might be a crucial mistake. It'd be helpful, I think, if you put the questions suggested by @rosemarya to your doctor for discussion, and we'd be interested in your reaction to the doctor's explanation, if you wish to share that with us. Martin

Should I get a 2 nd opinion. In November 2017 a complex renal cyst was accidentally discovered during a CT scan. Noted at 5 cm. December 2017 again noted as 4.3 cm, thick walled, exophtic renal cyst classified as Bosniak llf. My urologist did a follow up ultrasound in September 2018 and again identified as a complex renal cyst of 3.3 cm. Urologist has discontinued observation scans as such. I would think it would still need to be monitored especially being classified complex and llF. Any experience or advice.

November of 2017 a complex renal cyst was noted on an abdominal CT scan. Again noted in December 2017. Finally addressed in February 2018 with a new scan. And again a follow up in September 2018. Radiologist report said in first report 5cm complex renal cyst, thick walled. Next scan, 4.3 cm exophtic complex renal cyst of Bosniak llf. September ultrasound indicated 3.3 cm complex renal cyst and a 9 mm spleen cyst. My concern is my urologist says the renal cyst no longer needs watching that he is positive it is just a fluid filled cyst and has never mentioned the cyst in the spleen. Should I get a 2nd opinion?

@rensacb, I moved your messages about complex renal cyst to this existing discussion so that you can connect with others talking about renal cysts, like @predictable @kewpie8484 @rshardi and @charlena. To scroll through the past messages, click VIEW & REPLY.

While we wait for others to join the discussion, you may wish to read this information from Mayo Clinic about renal cysts https://www.mayoclinic.org/diseases-conditions/kidney-cysts/diagnosis-treatment/drc-20374138
The article includes questions to ask your doctor. Might these help you get answers to your questions from your urologist and to judge whether or not to get a second opinion?

@colleenyoung

@rensacb, I moved your messages about complex renal cyst to this existing discussion so that you can connect with others talking about renal cysts, like @predictable @kewpie8484 @rshardi and @charlena. To scroll through the past messages, click VIEW & REPLY.

While we wait for others to join the discussion, you may wish to read this information from Mayo Clinic about renal cysts https://www.mayoclinic.org/diseases-conditions/kidney-cysts/diagnosis-treatment/drc-20374138
The article includes questions to ask your doctor. Might these help you get answers to your questions from your urologist and to judge whether or not to get a second opinion?

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Thank you so much!

@rensacb

November of 2017 a complex renal cyst was noted on an abdominal CT scan. Again noted in December 2017. Finally addressed in February 2018 with a new scan. And again a follow up in September 2018. Radiologist report said in first report 5cm complex renal cyst, thick walled. Next scan, 4.3 cm exophtic complex renal cyst of Bosniak llf. September ultrasound indicated 3.3 cm complex renal cyst and a 9 mm spleen cyst. My concern is my urologist says the renal cyst no longer needs watching that he is positive it is just a fluid filled cyst and has never mentioned the cyst in the spleen. Should I get a 2nd opinion?

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Hi @rensacb. I'm weighing in at last because of my renal cyst to let you know about the positive signs I detected in connection with yours. Mine was ruled a simple cyst without any effect on my adrenal gland; yours, by comparison, is said to be complex, raising questions that always come up when these growths show up on imagery. Curious (as you are) about what I faced, I asked all of many questions of my urologist and my nephrologist. Their recommendations in response have been to leave mine alone but watch it for growth and for symptoms that might indicate the need for surgery. Here's why. If the cyst were complex it would be a benign cyst rated as a Bosniak One or Two. If it were rated Bosniak 2f, it would be uncertain as to malignancy, but watched more attentively over time to see whether it changes or causes serious symptoms. For me: No change in size or composition over 6 years, no symptoms causing worries. For me, this is a classic case of confidence in my medical team. Nevertheless, on two occasions recently, I have asked radiologists looking at images for other examinations to compare my cyst with past imagery, and they have said, "Don't worry." As a result, I don't feel the need for a second opinion on the cyst. Martin

@predictable

Hi @rensacb. I'm weighing in at last because of my renal cyst to let you know about the positive signs I detected in connection with yours. Mine was ruled a simple cyst without any effect on my adrenal gland; yours, by comparison, is said to be complex, raising questions that always come up when these growths show up on imagery. Curious (as you are) about what I faced, I asked all of many questions of my urologist and my nephrologist. Their recommendations in response have been to leave mine alone but watch it for growth and for symptoms that might indicate the need for surgery. Here's why. If the cyst were complex it would be a benign cyst rated as a Bosniak One or Two. If it were rated Bosniak 2f, it would be uncertain as to malignancy, but watched more attentively over time to see whether it changes or causes serious symptoms. For me: No change in size or composition over 6 years, no symptoms causing worries. For me, this is a classic case of confidence in my medical team. Nevertheless, on two occasions recently, I have asked radiologists looking at images for other examinations to compare my cyst with past imagery, and they have said, "Don't worry." As a result, I don't feel the need for a second opinion on the cyst. Martin

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Thanks for you info Martin. My concern is the radiologist classified it as a Bosniak llF, to watch and my urologist says I don't need to have any follow up scan. Also a 6mm cyst was noted in the spleen and it hasn't even been addressed at all. I'm concerned.

@rensacb

Thanks for you info Martin. My concern is the radiologist classified it as a Bosniak llF, to watch and my urologist says I don't need to have any follow up scan. Also a 6mm cyst was noted in the spleen and it hasn't even been addressed at all. I'm concerned.

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I can understand your concern @rensacb for a plan to maintain surveillance of a Bosniak 2f renal cyst. In my case, we have not scheduled followup imagery on my cyst; we are satisfied to look in on it whenever imaging for some other examination is scheduled. Another factor I have found to be important: My specialists and I regard our radiologists as highly technical experts for identifying tissues and their aberrations from their images, but not fully qualified to prescribe therapies to deal with what the radiologist sees and describes. Instead, my Primary Care Physician and the other physicians on my medical team take the lead, and I rely on them for treatments and treatment plans. Your spleen cyst is relatively small — about a quarter of an inch. Are any symptoms causing your concern there, or is it on your mind because it is a new anomaly? Perhaps your PCP will discuss with you how to pursue information about your spleen and whether you need a specialist to assess its status. Martin

@predictable

I can understand your concern @rensacb for a plan to maintain surveillance of a Bosniak 2f renal cyst. In my case, we have not scheduled followup imagery on my cyst; we are satisfied to look in on it whenever imaging for some other examination is scheduled. Another factor I have found to be important: My specialists and I regard our radiologists as highly technical experts for identifying tissues and their aberrations from their images, but not fully qualified to prescribe therapies to deal with what the radiologist sees and describes. Instead, my Primary Care Physician and the other physicians on my medical team take the lead, and I rely on them for treatments and treatment plans. Your spleen cyst is relatively small — about a quarter of an inch. Are any symptoms causing your concern there, or is it on your mind because it is a new anomaly? Perhaps your PCP will discuss with you how to pursue information about your spleen and whether you need a specialist to assess its status. Martin

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Thanks Martin for your very valuable information. My husband had a nephrologist so I called her office for a second opinion. Going in Tuesday afternoon for history and examination. Let you know how I fair.

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