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Mass in kidney turns out to be oncocytoma

To Your Good Health

DEAR DR. ROACH: I had a routine ultrasound to check my kidneys because my father (who is 80) has kidney disease, and his urologist said that it is genetic and that my sister and I should get a baseline screening. I am 50.

My doctor called me the following morning saying that there was an orange-sized mass, and I needed an MRI. The MRI report said that it was renal cell carcinoma. The doctor said my entire right kidney would need to be removed because of the size and location of the kidney.

Fortunately, eight days after surgery, I received the pathology report and was elated to read that it was an oncocytoma … in other words, benign. Apparently, only 5% of all solid masses found in the kidney are benign. I consider myself lucky and blessed.

— A.K.

ANSWER: An oncocytoma is a kidney tumor that looks very much like a typical kidney cancer (renal cell carcinoma) but normally acts like a benign tumor. They rarely invade normal tissue or spread to distant locations (metastasize). Sometimes people can have both renal cell carcinomas and oncocytomas, so it’s important to monitor a person after surgery.

DEAR DR. ROACH: After a recent kidney surgery, I now have Ogilvie syndrome, which was found the day after surgery when I had swelling and pain in my abdomen. This resulted in an NG tube being inserted and a couple of enemas. I was also taken off all narcotics because of Ogilvie syndrome.

I had never even heard of this before. Can you tell me anything about it?

— A.K.

ANSWER: Ogilvie syndrome is acute pseudo-obstruction of the colon. It is considered pseudo-obstruction because it looks like something is mechanically blocking the colon, but there isn’t any mass or obstruction at all. The underlying cause appears to be related to the nerve supply to the colon.

It’s more commonly found in hospitalized ill patients or residents in a long-term care facility like a nursing home. Surgeries such as hip surgery, cesarian section, and kidney transplantation are particularly associated with Ogilvie.

If the symptoms aren’t too severe, and your colon isn’t too dilated, then supportive care (like stopping all opiates, making sure your fluid and electrolyte status is good, and getting you to walk when you can) results in resolution for most people in about three days. It sounds like your surgeon is doing everything right.

ToYourGoodHealth@med.cornell.edu.

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