Expert: Claes-Gustaf Nordquist, M.D. - 4/25/2009

Question
My father had an epidermoid cyst removed from the pineal region of his brain in 2003.  The tumor was 95% removed but a small portion was left in his brain due to the risks associated with removal.

He recently began experiencing double vision and significant issues with mobility (equilibrium).  He has been diagnosed with a new tumor in the exact same area.  Interestingly enough, he had a MRI in February 2009 that had no tumor, yet the April 10th MRI showed a new mass with metabolic activity in the exact location as the previous cyst.

A subsequent biopsy identified the mass as a squamous cell carcinoma, primary to the brain.  The tumor is 30 x 9 mm.  Full body CT scan has found no other masses or abnormalities anywhere else in his body.  The doctors have reported this is an extremely unusual case, but not unprecedented which I have also been able to confirm via medical articles on the Internet.

The neurosurgeon and radiation oncologist are recommending gamma knife radiation with no additional radiation or other treatment except periodic full body CT scans to ensure this was primary tumor, not secondary. They strongly desire avoiding traditional surgery due to the scar tissue in the brain from the removal of the epidermoid cyst.  He is in good health other than the tumor.

Questions:
1) What is the success rate of gamma knife radiation for this type cancer and a tumor this size?
2) Is this the best treatment for a person with his history?
3) What is his life expectancy?

Answer
1. Since this is an EXTREMELY uncommon type of tumor case I'm not aware of ANY statistics with regards to success rates with any kind of treatment - and I do believe no such exists. However based on regular tumor experience I DO AGREE with his drs. that this suggestion most probably is not only the best treatment option but in reality also the ONLY one! The size of his tumor should be within the limits of a successful treatment too. 2. Please see above! YES! 3. Please see above. Due to the lack of statistics it is impossible to give you any probabilities but I do believe that this is his ONLY chance!
Without treatment this will kill him!