Orbitofrontal bone tumor - help

[Qwertytheclown]

I have a long history of a constant pressure headache deep inside the front of my head...as well as some vertigo issues...

I have posted some of my older MRI images in case you want to look, go here:  https://sites.google.com/site/robsaysrelax/

As you can see,  there is a lesion above my left eye in the bone.  The conclusion is that it's fibrous dysplasia, although,  that has never been confirmed.

Despite my perpetual discomfort, no one, including myself, has thought that surgery is something to take lightly,  but after many years, I have realized how much these symptoms of constantly having a headache have taken from my quality of life.

I have talked to my ENT (who is the primary one who follows me) as well as a neurosurgeon,  but I was wondering if you could tell me yourself what I would be facing if I actually went through with surgery?  I mean, looking at my scan, they wouldn't even really be touching my brain, right?  It was just be an operation on the bone with plastic reconstruction?    Would this be much the same risk level as removing a meningioma for example?  

I have not thought much lately about this, but lately my symptoms are bothering me worse for some reason, and I'm waiting to have a sinus CT.    Also, I worry about secondary problems...I used to get whole brain MRI's, but now they only do a sinus CT when it's been at least a year or I think I need to have it scanned again due to sympoms... is there something that could develop in my brain like an aneurysm that a sinus scan might miss?

Thanks for your thoughts,  I may be asking to speak with another neurosurgeon soon,  but it's so hard to make these decisions when my life isn't literally on the line, but my quality of life is very much on the line.  To put it in perspective, I haven't worked in years specially due to my headache issues.    I am 36 years old

[Daniel M Prevedello, MD]

Dear Qwertytheclown

I saw your imaging and it will be helpful to have a head CT, I only saw MRIs. I agree it most likely represents fibrous dysplasia. I am not sure your symptoms are related to that. So, it is rare that we perform surgery for FD. In general we do with a specific goal, like to decompress a cranial nerve etc.
The surgery in your case is not complex and it is superficial to your brain. On the other hand, I am not sure if it will cause your symptoms to go away or not...
Please let me know if you have any specific questions.

thanks

[rumpled]

I hope the doctor comes along - but in the meantime, I happen to have a friend that has fibrous dysplasia. If that is suspected you should see a specialist as certain things my friend tried with local doctors actually made her lesions grow.

From a support website for FD:
"There is no cure for FD, but there are treatments for the various problems associated with it. Surgery remains the mainstay of treatment for the long bone disease. Surgical treatment is complicated and is best performed by surgeons with experience with FD. Medications known as bisphosphonates (pamidronate (Aredia), zoledronate (Zometa), etc.) have been shown to be very effective in relieving pain. In general, surgery in the bones of the skull usually is not medically required. Although the nerves to the eyes and ears are often surrounded by FD, blindness and significant hearing loss occurs are uncommon."

NIH - national institutes of health used to do all the studies of it - not sure now with the changes.

[Qwertytheclown]

By the way, I have always wondered, but forgot to ask, does the tumor look to you like it's pressing on my frontal sinus bone?   I was told a long time ago that the pressure and pain is from the high metabolic activity in the lesion, but I wonder if some of it could be from actual pressure up against the sinus?