Originally posted by Scooter123:
Doc H. I am asking you to look at the units you have used in your post. Note, 4cm is equal to 40mm and in English that dimension is a bit over 1 1/2 inch. That isn't some little "nodule" that is something near the size of a golf ball.
BTW, I'm a manufacturing engineer in Automotive and had to cope with mixed Metric and SAE dimensions for a bit over 30 years now. On the plus side the standard unit of measure for the Metric system is the Millimeter, even great big Cruise Ships are dimensioned in millimeters.
Only does the Medical industry mix Centimeters and Millimeters and getting things mixed up, as I suspect is the case here, is the end result. If you have any voice at all in the medical profession you should really consider it your duty to get your industry to standardize on a single specific unit of measure. Because if you write a prescription for x milligrams and the pharmacist puts in x kilograms somebody is going to have a a very tough pill to swallow.
is correct - the size of a nodule is one indication for its malignant potential. Less than 4 cm (about 1.5") is less likely
to present as a malignancy absent other findings, and not generally indicated for surgical removal absent those other indications according to current guidelines. Size is one of the threshold criteria for determining adrenal malignancy, along with other indicators like hormonal findings and imaging abnormalities. Seventy-five percent of these "incidental" nodules are adenomas - sort of a fatty benign tumor (and only a "tumor" because it doesn't belong there) - and with HU of less than 10 on an unenhanced CT it's 98% specific that the OP's nodule is an adenoma, especially with the small size of 14 mm. Hence the urologist's recommendation. And again, Internet medical advice is worth exactly what you paid for it, hence my recommendation to consult with a PCP (and if genuinely concerned and the PCP or urologist recommend, with a good endocrinologist). But in my Internet opinion - for what it's worth - not needed given the description absent more significant findings. And I hear your recommendation. The problem with units of measure in medicine, in my experience, is more related to physicians' handwriting
than the units themselves.
*As an anecdotal aside to writing, resident notes always require a credentialed provider's co-signature. It is assumed that the co-signer reads the note. Some
providers tend to just sign - long hours, long notes. The Joint Commission, and Administrators, really frown on that. As did I as Department Chief, and all my previous staff. One of my residents, in the patient's permanent record
, at the end of his note wrote "I bet 5 bucks nobody reads this." Alas for him, I did. Mentoring ensued.
"And gentlemen in England now abed, shall think themselves accursed they were not here, and hold their manhoods cheap whiles any speaks that fought with us upon Saint Crispin's Day"