左中腎出現實性血管團塊，需要進一步檢查嗎？-泌尿科

solid mass with vascularity in left middle kidney？

Dead Dr.Pan,

I’’ve got an Ultrosound lab report about two weeks ago and they suggest me to take the CT Urogram to check out what’’s the solid mass with vasularity there in my left kidney. I need your comment on it and how bad it can be so I can make a decision to tell my father or not and where I can go under the medical care. Thanks a lot for your help. Here comes the Lab report,
Indications: 25-year-old female with hepatitis B. Please evaluate.
Findings:
The liver is slightly coarsened in echo texture. The liver measures
14.1 cm in longest dimension. No focal mass lesions are seen. There
is no evidence of intra- or extrahepatic biliary dilatation. The
common bile duct measures 3 mm. The gallbladder is normal without
gallstones, gallbladder wall thickening or pericholecystic fluid
collections.
The kidneys were measured 10.4 cm on the right and 10.1 cm on the
left. There is no evidence of hydronephrosis, mass, stones or
perinephric fluid collections. There is a hypoechoic mass in the mid
portion of the left kidney measuring 1.9 x 1.8 x 1.4 cm in diameter.
This appears to be a solid mass as internal vascularity is
identified.
The visualized portions of the pancreas and the spleen are normal in
echogenicity.

Conclusion:
1. Coarsened liver echo texture.
2. Hypoechoic mass in the mid portion of the left kidney.
Recommend correlation with CT urogram.

Claire Wu，20~29歲女性，詢問日期：2004/04/07

潘正欽醫師回覆-泌尿科

醫事人員經歷：衛生福利部臺南醫院泌尿科主治醫師

Dear Claire:
I’m sorry to tell you of my opinion about your condition. The Ultrasound report, mentioned to have a hypoechoic solid mass with vascularity at the mid portion of left kidney, may be more favored as a renal cell carcinoma, but benign cyst or other benign renal tumor can’t be excluded absolutely. And the CT or MRI examination is indicated for the next step.
I don’t known where you are now. But I think that you should be better to discuss with your family about it, then you decide where you will receive further examinations & medical care.

回覆日期：2004/04/07
資料來源：台灣e院 - solid mass with vascularity in left middle kidney

彙整補充說明

根據您的超音波檢查報告，左中腎出現的實性血管團塊（hypoechoic mass with vascularity）確實需要進一步檢查。
這種腫塊的特徵可能暗示著腎臟內的腫瘤，最常見的包括腎細胞癌（renal cell carcinoma）或其他良性腫瘤，如腎血管平滑肌脂肪瘤（angiomyolipoma）。
雖然報告中提到的腫塊大小為1.9 x 1.8 x 1.4 cm，這在某些情況下可能是良性的，但由於其內部有血管化的現象，這使得進一步檢查變得更加重要。

CT尿路造影（CT Urogram）是一種有效的檢查方式，可以提供更清晰的腎臟結構影像，幫助醫生評估腫塊的性質、大小及其對周圍組織的影響。
這項檢查能夠更準確地判斷腫塊是否為惡性，並且能夠檢查腎臟及泌尿系統的其他潛在問題。

在這種情況下，建議您與家人討論這個檢查的必要性，並考慮尋求專業的醫療意見。
您可以考慮前往泌尿科或腎臟科進行進一步的評估和檢查。
這些科別的專家能夠提供更具體的診斷和治療建議。

至於腫塊的潛在風險，腎細胞癌的風險隨著腫塊的大小和特徵而變化。
一般來說，腫瘤越大，惡性的可能性越高。
因此，儘早進行檢查和診斷是非常重要的，這樣可以及早發現問題並進行適當的治療。

在告訴您的父親之前，您可以先獲得更多的醫療資訊和專業意見，這樣可以幫助您更好地理解情況，並做出明智的決定。
無論結果如何，及早的檢查和診斷都是關鍵，這樣可以確保您獲得適當的醫療照護。

最後，請記得保持冷靜，並相信醫療團隊的專業能力。
無論檢查結果如何，及時的醫療介入都能夠提供最佳的治療方案。
希望您能夠順利度過這段時間，並獲得良好的醫療照護。