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What to do with a mesenteric mass?
Dec 4, 2000

Please, if anyone can help it would be greatly appreciated. I have been to a couple of good HIV doctors in Atlanta. I have a mass in my bowel and have had numerous tests-16 CAT scans (yes, sixteen), mega blood tests and Endoscopies and Colonoscopy's. They have done CT guided biopsies and to no avail. What do I do? I need someone to help me get treatment for this. I am currently on Mac meds along with HIV treatments and also pretty high doses of morphine and duragesic patches for the pain. The doctors here don't know what to do. Do any of you suggest radiation of chemo? One doctor says it's a MAC mass-another a tumor of unknown origin, another wants to split me open just to explore. Any suggestions or referrals would be helpful. Thanks for your time and expertise. Helpless in Atlanta. P.S. The mass is the size of a softball. Help!

Response from Dr. Pavia

Dear Helpless,

I can see why you feel helpless and scared. Your doctors sound like they are on the right track by recommending an open biopsy. The best way for you not to be helpless is to get a diagnosis and to know what you are up against. Nowadays, the surgeons do not necessarily "split you open". With the help of newer instruments the incision could end up small and healing does not have to be long and difficult.

The problem is that in someone with advanced HIV, the mass could be a lot of different things, and you need to find out. I am sure that a lymph node mass due to MAC or TB, or a lymphoma are on the top of the list of the concerns. Both are treatable, and removing the mass could help with your pain. Chemo is very useful for lymphoma, but it is not something you want to do without knowing exactly what you have. Other, unexpected infections could cause a mass, as could unusual tumors. Unless there is a reason that you are not in good enough shape to go through an operation, it is probably what I might be recommending if your were my patient. Good luck

ATP

Andrew T. Pavia, M.D.



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