I am seeking your opinion regarding my hard case, tumor recurrence . I am 28 years old male.try to smrize
Feb09: incidental finding by CT, Renal Tumor and Liver Tumor, Liver Tumor confirmed to be Focal Nodular Hyperplasia(FNH)
Mar09: Open surgery, Partial Nephrectomy, removed tumor. Histopathology confirmed it was OncoCytoma with clear margins. Surgery performed in King Faisal Specialty Hospital, one of the best hospitals in Saudi. Ultra sound and CT performed every 6-7 months.
Mar11: CT normal findings, FNH same size, No growth in Kidney.
Jan12: CT & MRI, Multi-Focal tumors in the same kidney(left side), starting on the same location as the previous tumor(upper Pole)! The 4 tumors are connected with the same root tissue & are located along the surf of the upper pole. No other tumors in the abdomen and chest area. FNH same size
Radiologists recommend radcal neph. Interventionist “refused” and did not recommend doing a biopsy. Sayed it is very critical and will not change treatment option.
Visited many Urologists (my mother is Dr). Sayed this is very very rare case.Some recommend Partial others Radical neph. All suggested this was very aggressive behavior. Recommended to test fresh slides (from old tumor) to double check. Tests performed last week on the fresh slides. histopathology conforms Oncocyt with NO RCC cells. They say the current tumor might be Oncocytosis which can have RCC hybrid.
I have 2 options
1-Radical Nep, open surgery, same hospital next week
2-Partial nep, Robotic surgery, in Ohio Clevland, after 3 weeks.
1)what are your thoughts regarding options? Can I wait for 3 weeks? Shall I go with partial or radical?
2)How common is Oncocytoma recurrence? Is this suggesting RCC or oncosytosis?
3)Where can this metastasize to?
4)If I go for radical, how that change quality of life? What if this occurs in the other kidney later?
5)Do I have to do brain/testicular CT?
6)Anything important to consider?
thanks