My father lives in Russia and he has been diagnosed with a brain tumor on the left side of his brain. The size of the tumor is 4.3 x 4.2 x 4.4 cm and there is 3.1 cm inflammation around it.
Considering my father's 40-year history of black-outs, and the fact that he has been essentially symptom-free and fully functional all this time, ( and recently with mild symptoms that were immediately improved greatly by steroids), upon reviewing the MRI and s-scans the Russian doctors diagnosed it as Meningioma, although they allow the possibility of it being malignant.
Three American doctors that I consulted looked only at the c-scans of relatively poor quality, and asked virtually no questions about the health history of my father. They think that because of the inflammation around the tumor and the size of the tumor, it is a malignant tumor of the brain and therefore not operable.
One American neurosurgeon, who reviewed the health history and the c-scan as well as the interpretation of MRI (not the actual pictures) believes that while it is not likely a meningioma ( it is not in the surface), and the tumor may well be benign and wants to operate.
This difference of opinions really surprises me, as the range of opinions I got is from "do not operate, he will die in 1-2 months" to "definitely operate, and it is quite likely benign'.
Any suggestions as to which of the doctors is likely to be on the right track?
Below is my father's health history. Any suggestions/opinions will be greatly appreciated.
During the past 40 (forty) years, my father has had the total of 5-6 black-outs, where he has warm sweat, loses consciousness, falls, and regains consciousness seconds later, with cold sweat. The last such episode happened 6 months ago. My father was on a ladder when he lost consciousness, fell down, hurt himself quite badly ( hit his head as well). After this incident my father lost sensation in his right hand and leg, and his speech became slurred. My mother also noticed that my father's face is was somewhat sagging on one side, and my father became more irritable and became more tired than usual. At that time he had been diagnosed with a stroke, although the doctors could not see the signs of a stroke in tests. My dad received treatment for a stroke.
During the past 5 months after the incident, my father's state had not deteriorated, and if anything, it improved- although the sensation did not come back, he was able to use his hand well enough to use it as usual and even write. His speech somewhat improved. All this time, my father remained fully functional, doing physical and intellectual labor. The speech deterioration was barely noticeable. He himself considered the symptoms very mild.
On October,2 1998 the Russian doctors paid attention to the fact that my father is not responding well to the stroke treatment, ( the sensation did not come back) and they also paid attention to the fact that my dad had had similar black-out episodes, although without the symptoms. They did a c-scan and found a large tumor, which they thought was the cause of the black-out episodes over the past 40 years. They diagnosed it as meningioma, and suggested surgery within 1 month..
Since the diagnosis was made, my father's speech had become somewhat more slurred, but the feeling in the hand had improved. Overall, the symptoms continued to be mild.
Last Friday (Oct 23) my father had an MRI done, and another Russian doctor thought that the tumor may or may not be benign. He again suggested surgery. The doctor also put my father on an anti-seizure medication.
As soon as my father started taking the medication, he felt much worse, and his speech got dramatically worse. The doctors were not sure if this was connected to the medication, but suggested that my father discontinue it. My father also started taking Prednozolone, for controlling the inflammation around the tumor.
One day after my father stopped taking the anti-seizure medication and started taking Prednozolone he has and dramatic improvement in his speech and his general state. He continues to be fully functional.
Please contact me at zhenya_abbruzzese***@**** , or (503) 241-8036 ext 173 at work or (503) 245-6022 at home if I can answer any questions.
Thank you very much,
This difference of opinion does not surprise me unduly given that all the American doctors have to go on are poor quality scans, it underlines the fact that the definitive diagnosis of any tumor type can only be made by removakl or biopsy of the tumor itself. Sometimes a mass have an absolutely classical apperaance and the diagnosis may be easy, in this case there seems to be a gray area so a definite opinion cannot be given without the biopsy.
Without the benefit of even seeing the scans we really cannot even venture a definite opinion.
As pointed out in the introduction to the forum we can neither contact you directly or nmake a diagnosis for you. I can however venture some thoughts on what you have told me, but please bear in mind this is a discussuion of possibilities, not a diagnosis.
The fact that the tumor is surrouded by edema suggests that it is more likely to be superficially located malignant tumor than a benign meningioma, although there is a possibility it could be that rare entity a malignant meningioma.
The dramatic response to prednisone suggests that the edema has resolved with treatment which is usually a characteristic of malignant tumors.
An important point is that just because a tumor is malignant it does not mean it is inoperable, especially if it is superficially located.
The response to the seizure medication suggests that the level was too high, this is amenable to adjustment of the dose and would be important because a superficially located tumor carries a high risk of causing seizures.
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