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Is Severe Pain In The Lower Legs A Sign Of Nodule Metastasis?
Question: I am 46 female.
5"2 115 lbs
Prior smoker 1 pack /day for 14 years
Quit 18 years ago.
March 2016 Ct scan chest for unrelated purposes revieled a 4 mm noncalcified nodule in the left upper lobe.
Rec follow up was instructed at 12 months.
I have a bone pain in my left lower leg ( tibia) so I requested another ct scan at ten months because I feared the nodule metastised.
Repeat scan
1/3/17 ( 10 months from previous)
Nodule remained stable.
1)What is the chances that this 4 mm nodule is a cancer if it remained stable?
2) if it were a cancer, could a small 4 mm nodule metastises?
3) if yes, would it metasisize to the tibia?
4) should I continue to monitor it with repeat ct scan and if so, when and for how long?
Thank you
5"2 115 lbs
Prior smoker 1 pack /day for 14 years
Quit 18 years ago.
March 2016 Ct scan chest for unrelated purposes revieled a 4 mm noncalcified nodule in the left upper lobe.
Rec follow up was instructed at 12 months.
I have a bone pain in my left lower leg ( tibia) so I requested another ct scan at ten months because I feared the nodule metastised.
Repeat scan
1/3/17 ( 10 months from previous)
Nodule remained stable.
1)What is the chances that this 4 mm nodule is a cancer if it remained stable?
2) if it were a cancer, could a small 4 mm nodule metastises?
3) if yes, would it metasisize to the tibia?
4) should I continue to monitor it with repeat ct scan and if so, when and for how long?
Thank you
Brief Answer:
Chances are less, can metastasize to tibia. Monitor for some more time
Detailed Answer:
Hello XXXXXXX
Thanks for posting your query on HCM.
The chances of the small nodule in the lung being noncancerous increase, since it has not increased in size in last one year though they do not become nil. A minimum of 2 years of observation is required to say that chances are remote.
Yes even a small nodule can metastasize and can metastasize to any bone including tibia.
Yes the monitoring should continue as I have said above with CT Chest. You may also get a whole body PET scan done after consulting your local Pulmonologist.
Feel free to ask further.
Take care.
Chances are less, can metastasize to tibia. Monitor for some more time
Detailed Answer:
Hello XXXXXXX
Thanks for posting your query on HCM.
The chances of the small nodule in the lung being noncancerous increase, since it has not increased in size in last one year though they do not become nil. A minimum of 2 years of observation is required to say that chances are remote.
Yes even a small nodule can metastasize and can metastasize to any bone including tibia.
Yes the monitoring should continue as I have said above with CT Chest. You may also get a whole body PET scan done after consulting your local Pulmonologist.
Feel free to ask further.
Take care.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thank you
I appreciate your response in detail
May I ask you in regards to the pain in my tibia
Pain started four months ago in tibia bone.
9/20/16 Had xray was normal
11/24/16 mri without contrast showed stress changes without fracture abd without a vascular necrosis
11/27/16 ct scan leg from knee to ankle was normal
1/3/17 xray of leg was normal
With these test above mentioned have seen metastasis?
Do these test rule out metastasis?
Have you actually ever seen a patient that had such a small nodule metastasize and would it not have to go to the lymph nodes before reaching the tibia?
Im not sure if these tests rule it out
Thank you .
I appreciate your response in detail
May I ask you in regards to the pain in my tibia
Pain started four months ago in tibia bone.
9/20/16 Had xray was normal
11/24/16 mri without contrast showed stress changes without fracture abd without a vascular necrosis
11/27/16 ct scan leg from knee to ankle was normal
1/3/17 xray of leg was normal
With these test above mentioned have seen metastasis?
Do these test rule out metastasis?
Have you actually ever seen a patient that had such a small nodule metastasize and would it not have to go to the lymph nodes before reaching the tibia?
Im not sure if these tests rule it out
Thank you .
Brief Answer:
The imaging tests mentioned by you do not show any lesion in the tibia.
Detailed Answer:
The imaging tests mentioned by you do not show any lesion in the tibia including metastasis. There can be many other causes of pain in that area including muscle strain or even osteoporosis. Orthepedoc surgeon is the best person to advise you on this.
These tests only say that the part of the tibia imaged has no lesion.
No i have not seen a specific case of of a small lung nodule which is cancerous metastasize to tibia but it can go to tibia directly because mode of spread is different.
Wishing you the best.
The imaging tests mentioned by you do not show any lesion in the tibia.
Detailed Answer:
The imaging tests mentioned by you do not show any lesion in the tibia including metastasis. There can be many other causes of pain in that area including muscle strain or even osteoporosis. Orthepedoc surgeon is the best person to advise you on this.
These tests only say that the part of the tibia imaged has no lesion.
No i have not seen a specific case of of a small lung nodule which is cancerous metastasize to tibia but it can go to tibia directly because mode of spread is different.
Wishing you the best.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
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