From the Guidelines
The 3mm nodule in the fat anterior to the psoas muscle is likely a post-surgical change rather than a concerning finding, and given its stability on subsequent scans, it does not warrant any change in the current follow-up schedule. Based on the information provided, this nodule was present after partial nephrectomy for a 1.3cm chromophobe renal cell carcinoma (RCC) and has remained stable, which is consistent with normal healing or scarring from the surgical procedure 1. The American College of Radiology guidelines for post-treatment follow-up and active surveillance of clinically localized renal cell carcinoma suggest that imaging surveillance of the chest and abdomen be performed after primary treatment for RCC, with the frequency and modality of imaging depending on the risk stratification of the patient 1. Given the patient's history of T1a chromophobe renal cell carcinoma that was completely removed with clear margins, and the fact that the nodule has remained stable over time, it is likely that this finding represents expected post-surgical changes rather than recurrence. Some key points to consider in this case include:
- The nodule's small size and stability on subsequent scans are reassuring features that suggest a benign etiology 1.
- The patient's history of partial nephrectomy for a small RCC, which is associated with a low risk of recurrence, also supports the notion that this finding is likely benign 1.
- The American College of Radiology guidelines recommend a baseline study between 3 and 12 months after partial nephrectomy, followed by yearly imaging for 3 to 5 years, which is consistent with the patient's current follow-up schedule 1. Therefore, the patient should continue with their regular follow-up schedule as recommended by their urologist, which typically includes periodic imaging to monitor for any concerning changes.
From the Research
Clinical Significance of a 3mm Nodule
The clinical significance of a 3mm nodule in the fat anterior to the psoas muscle, which appeared after partial nephrectomy for a 1.3cm chromophobe renal cell carcinoma (RCC), and has been stable on subsequent scans, is not directly addressed in the provided studies.
Relevance of Provided Studies
- The study 2 discusses the management of solitary pulmonary nodules (SPNs) and their potential for malignancy, but it does not specifically address nodules in the fat anterior to the psoas muscle.
- The study 3 focuses on surveillance strategies for melanoma patients and does not provide information relevant to the clinical significance of a 3mm nodule in the context described.
- The study 4 examines pulmonary nodules and metastases in colorectal cancer, which is not directly relevant to the scenario of a nodule appearing after partial nephrectomy for RCC.
- The study 5 discusses imaging, biopsy, and non-surgical treatment of thyroid lesions, which is not applicable to the situation described.
- The study 6 reviews surveillance guidelines for serrated polyps and their association with colorectal cancer, which does not pertain to the clinical significance of a 3mm nodule in the fat anterior to the psoas muscle after partial nephrectomy for RCC.
Conclusion on Relevance
Given the information provided, there are no research papers that directly assist in answering the question about the clinical significance of a 3mm nodule in the fat anterior to the psoas muscle after partial nephrectomy for a 1.3cm chromophobe renal cell carcinoma. The studies provided do not address this specific scenario or type of nodule.