Hi,
Lesion in Chest following radical
nephrectomy and a partial nephrectomy on the
other side is most likely to be metastatic.
A CECT of the chest would generally suffice to ascertain the nature of lesion and
provide us with a working diagnosis most of the times.
Rarely, a CT/
Bronchoscopy guided
biopsy could be considered if the lesion in
question looks doubtful of being metastatic.
more accurate than a
CT scan would be to subject your father to a FDG
PET CT. PET
CT is highly accurate in diagnosing metastases from kidney cancers.
The advantage of having a PET CT in your father is that not only will it obviate
the possible need for a biopsy, it will also pick up other metastases if any, as
small as 3mm leading to better staging of his condition.
accurate staging at this point of time will have therapeutic implications.
Metastatic disease in
Renal cell carcinoma is still not very disheartening unlike
many other cancers as cure could still be achieved by resecting the recurrent
lesions if technically possible ( single metastatic deposit or confined to one
area of lung/liver, for instance).
Do not worry. there are many drugs available now which can push the disease into
remission for
prolonged periods of time, which is most likely to be so in your
father's case considering almost 3+ years taken for the cancer to come back(if it
really has).
Best Wishes,
Srivatsa