It's been just over 4 years since my pituitary surgery. The residual tumor seems to be stable for the moment, having shown a growth of about 2mm in the past 4 years. I am still experiencing some swelling of the lower legs, and I have started gaining weight again, in spite of taking several diuretic drugs, to the tune of 40 pounds in the past 2 years. I have developed gout in both feet and ankles and sometimes it's almost impossible to walk. I used a drug called Naprelyn for awhile, then switched to Indocin to keep that under control. I am short of breath even with minimal exertion, and have been having frequent heart palpitations.
On October 10th, 2001, I had two acute attacks of shortness of breath, dizziness, nausea and chest pain. When the second attack didn't resolve with rest as the first had, I went to the emergency room. I felt that I was either having a heart attack, or had developed pulmonary emboli (blood clots in the lungs). After the cardiac testing and EKGs didn't show a heart attack, a CT scan of the chest, doppler studies of my legs, and VQ lung scan were performed. The lung scan showed multiple blood clots in the lungs, but the doppler didn't show any clots in my legs. I was started on Heparin (an IV blood thinner) and admitted to the intensive care unit.
The next morning my doctor came in and told me that the CT scan showed a huge thrombus (blood clot) in my inferior vena cava (the main vein in the body), and said that was probably where the clots in my lungs had come from. Then he dropped a bombshell - he told me that the CT scan had also shown a mass on my left kidney - most likely a renal cell carcinoma. He quickly arranged a consultation with a urologist who told me it needed to be removed - along with the entire left kidney.
I was transferred to a nearby major medical center, and kept on blood thinners. On the second day, I developed a blinding headache, and the following day, my left eye was paralyzed. An MRI of my head didn't show anything, but it was assumed that this paralysis was caused either by a small blood clot or bleed, or by the pituitary tumor. The blood thinners were stopped. An inferior vena cava filter was inserted to prevent more clots from traveling to the lungs. After about a week, the paralysis had almost completely resolved. More testing was done to determine if the cancer had spread to any other organs. The bone scan and MRIs of my chest and abdomen didn't show any signs of metastasis. I was started on Coumadin (an oral blood thinner), and discharged to home on October 22 to await surgery.
On December 17th, I re-entered the hospital for surgery. The next day, my left kidney and the tumor were removed via hand-assist laparoscopy. Pathological testing of the tumor showed that it was a clear cell renal carcinoma, Grade I - meaning that it had not invaded the kidney itself, or the surrounding tissue. The surgeon said that this was the BEST kind of kidney tumor to have (if there IS a good one), and the prognosis was excellent. The only follow-up I will need is yearly chest xrays for the next 10 years, since IF this type of cancer spreads, it's usually to the lungs first.
