Re: brain tumor?

Posted By ghd on November 22, 1998 at 19:27:23:

In Reply to: Re: brain tumor? posted by CCF neuro MD  on November 22, 1998 at 15:09:36:






: : I am a 35 year old who had never been in the hospital.  I had a seizure during my sleep and an MRI indicated an orange size tumor in my temporal lobe. I was told I had a glioma II that could not be removed.  A craniotomy was recommended to rule out cancer and remove any of the tumor not intertwined.  The biopsy samples came back with no abnormalties and the doctor went on the assumption of vasculitis. I was on prednisone for 6 weeks.  The second MRI showed no change and vasculitis has basically been ruled out.  I was told I had a glioma I, although this is usually in children and in a different area of the brain.  After the appt., I got a copy of the MRI report.  The doctor doing the report stated that the mass had been missed when taking samples of the tumor.  The neurosurgeon is certain he did miss all samples, especially in a mass this size.  He is now referring to it as a glioma I/II.  The only "treatment" I am on is dilantin to avoid seizures and was told it was my choice to stay on that.  If I decided to stop taking it, I would have a 1 in 100 chance of a seizure.  I am to return in 6 months to check the growth.  If the same, check it in a year.  I feel fine most of the time (physically anyway).  My memory is not as sharp as it was about a year ago.  This mass/tumor is 5x5x4.  Does it seem possible this could be missed during surgery?  Can I have a mass this large, one seizure, and basically feel fine for 2 months?  Any comments or ideals?  Thank you so much for this forum.  I read it daily.
:


  =
: I cannot say what happened during surgery, it is hard to imagine that a mass
: this size was missed but if the surgeon and radilogist say so we must assume
:  it is true.
: The symptoms produced by a mass are more dependent on location than size,
: it is possible to have a large mass in a temporal lobe with out symptoms
: although memory function is located in the temporal lobes so it is not
: surprising that you report some problems in this area.
: I think your chances of having a seizure are higher than 1% , you
: already had a seizure before treatment , this makes it much more likely
: that you would have a seizure if you came off medication, this is a typical
: result of a mass in the temporal lobe as many seizures origionte in
: this part of the brain.
Sorry, I made a typing error.  The surgeon is certain he did NOT miss the
tumor for all of the biopsy samples.  Does that change any of your answer or add anything?  Does a biopsy with no abnormalities make sense? Thank you.



    


: I am afraid I still cannot say what happened at the time of the biopsy,
it is possible that the mass is made up of a mixture of abnormal and
abnormal tisue in which case the point at which the biopsy was taken
was not a repersentative sample of the entire mass.

I'm assuming you mean it is possible for the mass to be made of normal and abnormal tissue-if 3-5 samples were taken and no abnormalties were found, how can it be determined that this is a glioma?  If all the samples happen to be normal  (even when it is possible for there to be normal tissue) what makes a glioma  the diagnosis? Is there a way to determine if this is definitely a glioma or a missed biopsy attempt other than another craniotomy?  If it was actually a missed tumor biopsy, then I can't even be certain that it is not a glioma III-am I understanding this correctly?  Again,
thank you so much for you time and help.