Benign Hemangioma/Meningioma causing frontal lobe compression....please help doc

[Emak]

Here is some photo's of my supposed Hemangioma on the MRI and CT films (note the captions, the CT is september 2004 and the MRI is of May 2005. I hope that a doctor will drop by this thread and take a look at these films also...Here is the scans of my films:

http://www.geocities.com/billybo94102/photopagetan.html


My symtoms are constant low to mid grade pressure headache for 5 months strait, often temporarily relieved greatly by applying pressure to frontal (forehead) sinuses; heavy headed feeling; blurred sense of reality, and difficulty on concentrating especially focusing on moving objects; dizzy spells, and continuous anxiety for absolutely no reason whatsoever (no history of such).   Constantly blocked nose (swolen turbinates) which led to a diagnosis of allergies but sinus CT is crystal clear with no drainage.  I am a 28 year old male with no history of medical problems. My doctors dismiss the idea that this is a problem after extensive blood testing is all negative, this is the only abnormality left in the picture. It appears to me that the left frontal lobe is being compromised (mashed down) by the lesion.
Please tell me if I should be concerned with this lesion,  my doctors seem to be dramatically downplaying the possibility that this is causing my problems and put me on Lexapro for depression.

Thanks very much

[Skumar]

Recently I had pain in my upper right abdominal , As per the doctor I was gone through CT Abdominal/Pelvis with contrast. their findings as follows.
The lung bases are clear. There is small peripheral hypodensity in the right lobe of the liver. this appears to fill in on delayed images. The liver is otherwise unremarkable. Speen,Pancrease and adrenal glands appear normal . There is a horseshoe kidney , but no focal renal abnormality is demonstrated. The gallblader and bile ducts are grossly unremarkable, although ultrasound would be better for evaluating for gallstones.The bowels and bladder are grossly unremerakable. there is no free fluid or lymphadenopathy.
Then I did ultrasound and their findings as follows.
The liver appears normal in size .In the periphery of the right lobe there is a 1.7cm X 1.7cm X 1.8cm uniformly hyperechic mass which correlates with the peripheral hypodense lesion seen on CT. It's echogenicity is most characteristic for benign hemangioma. No other focal liver abnormalities are demostrated . the gallbladder and bile ducts are normal. Visualized portions of the pencreas are unremarkable and aorta is normal in caliber. the right kidney shows no hydronephrosis.
Suggestion was to follow up ultrasound in 4-6 months is recommended to isure stability and normal gallblader and bile ducts.

[Samiline]

Hi Emak, I have just same symptoms as yours including spondilytis. I got up now in the middle of the night due to severe pain. I have planned to vist radiologist for brain MRI 2mrw. Neurologist told me it is Migraine but Dr. want MRI to confirm its not something else.

[Emak]

Doctor,   I know you can't tell what type of lesion it is, but can you finish my question by telling me if it looks like my left frontal lobe is being compromised in any way by being compressed?

thanks

[Emak]

I'm not rich to afford the $565 for a second opinion from Cleveland Clinic.   Surely the purpose of this site isn't what I think it is?   =(

[Emak]

My ENT doctor consulted the radiologist and for some reason he thinks its a "boney lesion" and wants a radionucleotide bonescan done.

[Emak]

Hi doctor,   I had a negative HIV test, and I also had a negative MRA of the brain.  Would this have ruled out an aneurysm?   Thanks.

[CCF-Neuro-M.D.-PW]

I did try to review the images on your website - I cannot give a formal interpretation though over the internet, and also teh quality of the images (even on the 2nd site) quite a bit poorer than reading the images in hand. Perhaps a formal 2nd opinion by sending the images to the eCleveland Clinic Radiology film consult service might allow a better interpretation of higher quality images

There is a mass present, which seems to be extra-axial, that is, outside the brain matter itself. With the above symptoms, the differential diagnosis could include a granuloma (such as sarcoid, syphilis), an abcess (such as fungal, or bacterial) or tumor (such as a meningioma), or arterial aneurysm. Good quality scans shoudl be able to differentiate, and a vascular study should exclude a partially thrombosed aneurysm. Once a vascular lesion is excluded, a biopsy of the mass may provide the definitive answer. A HIV test (which can presidose to brain lesions) may also be indicated.

[Emak]

Thank you Christie,  I would hate to have a surgery to remove this only to find out it was not the cause.  But nothing else has come to light.  I wonder what else it could be.  I've been tested for auto-immune disorders, lupus, lyme, b12, and several others i do not remember.

[Emak]

Finally, I forgot to mention that I also have mild spondylosis in my C2-C5  cervical spine and moderate spondylosis on the right side between C4-C5.   Sometimes I have pain in the "moderate" area.   I have often wondered if this could be a source of referred pain (the pressure headache) but I do not know how it could cause the other symptoms I have had such as feelings of severe confusion, dizziness, constant swolen turbinates/lost sense of smell and unexplained anxiety.   The muscles in my forehead also feel very "stiff" and "full."    In addition, I occasionally get muscle spasms (which I have never had previous to May)  which usually are 3-4 inches below my naval, in my legs, or in my back.   This is a minor annoyance in and of its self, but how does it fit in to the "puzzle" I have to wonder.

[Emak]

Here I have posted better MRI and CT pictures, these pictures are much larger and more detailed than the link above:

http://www.angelfire.com/ab9/mriphotopage/mri/

[Emak]

The resident ENT at UAB (univ. alabama at birmingham) hospital called me and said they think it may not be a hemangioma at all now, but rather possibly some sort of bony growth (i don't know what that means).   But the nuclear bonescan has me rather alarmed.   I don't know what is even involved with this test but i know it involves injecting dye in my blood again (gross)  is this similar to CT dye or more like MRI dye?   Does it involve radiation exposure similar to a CT?

I am extremely interested in hearing what the doctor here thinks.

Worried,
Emak

[Christie2004]

Be patient--it may take a while to get an answer from the doc here, especially due to the holiday weekend.

I had a bone scan, and all it involved was getting an iv injection and waiting an hour, then about 20-30 minutes laying still under the scanner.  Pretty simple, as tests go.

I hope everything turns out ok for you.

[Emak]

Sorry to make a third post, but... oddly enough my ENT doctors resident just called me and told me that he just reviewed my films with a radiologist and they think that it is probably not a angioma but rather a  bone growth of some sort, so they want to schedule me for a "radionucleotide bone scan".    I don't know what to make out of this now really, I don't know if they expect it "could" be something more serious or if they are just doing these things for educational purposes of their residents?

I'm even more lost now,  please advise your opinion doctor.  Thanks once again.

[Emak]

Also, I forgot to mention that two radiologists completely ignored this lesion and didn't mention it in the CT/mri reports, but, finally at a major University a resident radiologist finally reported this finding.  Thanks again

[cranky]

They found a very large hemangioma in my spinal vertebrae so I researched it online and found that they can cause severe pain.  I don't know if that applies to the brain but it can happen in the spine.