37M 1.2CM X 1.17 CM Renal Cyst Causing Considerable Discomfort?

Me: * Male

37 years old

5' 11"

150 Lbs

White

Healthy: Run ~20 miles per week, bike 10. Resting heart rate ~50bpm. Blood pressure 115/75ish. "Healthy" diet ("What does that mean?" Too much to type here, but serious thought/research goes into it; not an “extreme” diet; balance of animal protein and greens; low glycemic.)

My questions upfront are (but please read details):

1) Could a kidney cyst smaller than a marble really be causing substantial discomfort and develop so quickly? I’ve passed full turkey dinners through my ascending colon that were way less uncomfortable than this.

2) If not a kidney cyst, what else could it be?

3) What questions should I be asking my physician and nephrologist?

Details--

6+ Weeks ago: Started to feel a slight pressure at the tip the 10th and 9th rib, on my right hand side like someone constantly had two fingers resting there. The pressure is constant, and does not change when eating, bowel movement, waking, sleeping, hydrating, etc.

3 Weeks ago: Pressure became more noticeable, with defused pressure (not yet pain) noticeable in abdominal muscles. The pressure is constant, and does not change when eating, bowel movement, hydration, etc.

2 Weeks ago: All previous symptoms, but now notice it in the back muscles on the right hand side of the spine. The pressure is constant, and does not change when eating, bowel movement, hydration, etc.. Movement in certain positions makes the pressure more noticeable. Flex lower back; feel it there. Bend over, feel it in the 9th/10th rib. My 45-minute commute home is starting to get fairly uncomfortable; feels like there is a baseball sitting behind my 9th/10th rib. Sleeping in certain positions is now uncomfortable. 400MG (2 pills) of ibuprofen doesn’t touch it (tried this 3 or 4 times.) Area is starting to cramp when I run. Time to go see doc.

1.5 Weeks ago: Went to doc. X-ray negative. Physical digital pressure exam by doc. He says he doesn't feel anything; I don't feel any extra pain with him poking into my ribs and back. Says x-ray shows I might be a little constipated. Asked about BMs. One a day, but maybe a little less regular than normal. Prescribed Miralax; said if I don't feel better to get an ultrasound of upper right quadrant (gave me a referral.) Took Miralax for 5 days. Day 4 and 5, stool is getting pretty loose and almost diarrhea, and I feel empty, but that pain/pressure at the end of my ribs, abdominal, and in back didn't change one iota. Also doc ran tests while I was there (CBC, urine test, and serum test). Truncated results are below (was told nothing was abnormal.)

4 days ago: Ultrasound (fasted 12 hours prior.)

Today: Report received from ultrasound as follows--Liver and Pancreas have homogeneous echogenicity. Gallbladder physiologically distended without abnormal gallbladder wall thickening, pericholecystic fluid, or gallstones. Common bile duct measures 3mm. Right kidney measures 11.1 cm in length, containing an interpolar cyst of 1.2 cm x 1.17 cm. Visualized upper abdominal aorta and inferior vena cava are within normal limits.

I was referred to nephrologist for follow up, which will happen in the next 5 days or so, with my doc noting the cyst is the probable source of the problem.

Test results (full test results available upon request)

CBC:

WBC 5.1K/uL

RBC 4.60M/mm3

HGB 14.3gm/dL

HCT 41.0%

MCV 89.1fL

MCH 31.1pg

MCHC 34.9g/dL

RDW 39.6fL

PLATELET COUNT 157K/cumm

CMP:

PROTEIN 6.7g/dL

ALBUMIN 4.5g/dL

ALKALINE PHOSPHATASE 33IU/L

ALT (SGPT) 24IU/L

AST (SGOT) 21IU/L

BILIRUBIN 0.6mg/dL

A/G RATIO 2.0mg/dL

GFR BLACK/WHITE >60mL/min/1.73m2

Urine:

Blood, keytone, bilirubin: Negative

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