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Was wondering if Vat's surgery missed a lung nodule , would it be possible to repeat the surgery and is this a common out come when you are dealing with small SPN? JUST WONDERING
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Was wondering if Vat's surgery missed a lung nodule , would it be possible to repeat the surgery and is this a common out come when you are dealing with small SPN? JUST WONDERING
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Reply # - February 17, 2014, 09:27 PM
Reply To: surgery again?
It's not common, but it's possible to have that happen. The surgeons will often have the interventional radiologists place a small wire into the nodule (tethered in place with a very tiny coil) to guide the surgeon to the right area to resect. Without the guide wire placed by interventional radiology, I suspect far more lung nodules would be missed. The main reason it is missed now is when a surgeon doesn't think it'll be needed because the nodule is suspected to be large and firm enough to be palpable but turns out not to be.
Good luck.
-Dr. West
Reply # - February 18, 2014, 05:56 AM
Reply To: surgery again?
Well as you mentioned about the small coil placement before surgery to mark the nodule , yes I had this done prior to surgery as well , it was a small 8.7mm SPN in my left lower lung, they took out large wedge sections and the pathology report mentions a 8mm nodule that was found after further sectioning where the coil was close to, but in the final findings it only mentions a 4mm lymph node, no mention of anything even close to the 8.7 mm SPN, So DR is checking with the pathologist as to why the different sizes . He mention a follow up scan for me , the tissue samples wedges ( quite large ones) were all benign , so I said the error is with the the report so please get with the pathologist and see why he list two different sizes. My Dr then proceeds to explain the formalion that they place the tissue sample in hardens the tissue and dries it out so he thinks that is what happen to explain the two sizes mentioned but that he would check with the pathologist and get his thoughts. So I guess my question is if this advance CT guilded placement failed the first time to locate this Spn what makes me so sure it will work the second time around? Not really ready for a REDO, So the question is should I be good with the Dr explanation of the drying out process and that the nodule is gone or should I push to get answers? Any advice would be helpful
Reply # - February 18, 2014, 06:39 AM
Reply To: surgery again?
I think these are very specific issues that we can't answer, as only the people directly involved with your care can address them. Probably most fruitful will be to hear what the surgeon learns after speaking with the pathologist.
Good luck.
-Dr. West
Reply # - February 19, 2014, 06:01 PM
Reply To: surgery again?
Well I talked with the DR this evening and he said he had spoken with the path Dr and the explanation for the different sizes in report ( gross-final findings) he pulled up the report and stated that the lymph node was surrounded by scar tissue and so the lymph node was the final finding so sound reasonable to you? He said if I felt the need we can rescan in 6mts, but the path Dr as well as himself felt they did get the nodule . So what do you think? Sound reasonable?
Reply # - February 19, 2014, 09:52 PM
Reply To: surgery again?
It's not that rare to have a discrepancy between the imaging result and the path findings. Yes, I think the explanation and the plan sound very reasonable.
Good luck.
-Dr. West