cavernous hemangioam vs brain tumor

[reddeck]

my 3 yr old son was dx with a brain tumor or a cavernous hemangioma. he is completly asymptomatic......a ct , mri and mra were done as a result of an accident . the neuro surgeon can not tell us which it is because there is a lot of calcification around the lesion.......also he said it is missing the rings aroud it which would confirm cavernous hemangioma but it does not appear to look like a typical tumor either. the plan is to repeat mri and do spectroscopy with it (3mos later) and continue to rescan every 3 to 4 mos for a year to see if there is a change. what does this mean for my son??? i realize the danger of surgery outways the benefits right now but this is very scary. should he be kept out of activities??  does a cavernous hemangioam have to have these rings?? what is all the calcification mean????? could this be cancer??  is this a omninous prediction of my son's life expectancy?? thank you for your help  signed a very worried mom.  nb..we have seen other surgeons that say the same thing......some want to repeat scans every 6 wks some want to only do them once a year and the one we are with now is every 3 to4 mos for a year.  which plan seems most appropriate???

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

Sorry to hear about your son. It is understandable that you are concerned about his brain lesion. Generally speaking, many people with a cavernous malformation are able to live absolutely normal, full lives (depending on the location and size which were not provided in the post.) Like your son, it's often found on accident or don't become noticed until much later in life like age 20-40. Most of the time they are clinically silent and you would never know they were there unless it bled (the annual chance of bleeding is less than 1%) or you happened to have a seizure,headache, or neurological deficit such as facial weakness (again, very much dependent on where this lesion is). Most of the time when it does bleed, it's just a very, very small amount and you wouldn't know it at all. The hemangioma tends to calcify (just its nature) and the blood becomes hemosiderin which is a blood byproduct (think:old blood) which leaves a typical dark ring on the MRI around the lesion. All that means is that there's been evidence of bleeding. As for the possibility of tumor, I would have to personally review the MRI to make an accurate comment. But yes, there are some tumors that calcify such as an oligodendroglioma which again, patients can live relatively normal full lives with.

There is no right answer as to how often you would scan this. 3months sounds appropriate and what is often recommended here, but there is nothing wrong with 6 weeks either. Choose a neurosugeon you trust and allow him/her to help guide you in the management of your son's condition. Good luck.

[jenn5va]

Hello! I am not a doctor but was diagnosed with a cavernous angioma about 2 years ago.  I am now 26 years old but at the time was 24 and just returning home from my honeymoon in Aruba.  I had been having these weird episodes of my arm tingling and finally went to get an MRI, which showed a cavernous angioma (with a ring, indicating it had leaked some blood).  Eventually, I found an excellent nuerosurgeon who advised me to have surgery, saying that if I were his daughter, that is what he would recommend.  It was a very stressful time, as you can imagine, because most of the doctors I went to gave me very wishy-washy responses.  Because we plan to have children (and pregnancy causes blood flow to increase), I felt that I should get it over with before it bled and caused permanent damage.  I ended up having the surgery (with brainmapping) and I am now fully recovered. You just have to weigh out the risk, depending on the size of the legion and more importantly, where it is and what would be affected if it bled.  If you need someone to talk to, just let me know.  I answer questions all the time.  Jennifer

[vega]

I had a cavernous hemangioma removed when I was 14 (now 24), and it worked out really well.  I had had petit mal seizures (like panic episodes) for a few years before, but I just thought I was different.  I finally had a grand mal seizure, and the MRI pointed out the obvious problem.  It was in my front left temporal lobe, and if it had not been removed, it would have continued to get worse.  If it's in a part of the brain that isn't really utilized, maybe the situation for your son is different.  The surgery wasn't bad at all.  Please contact me if you need any more information.

[DanielC248]

A related discussion, Cavernous Tumor or Lesion was started.