AboutClaes-Gustaf Nordquist, M.D. Expertise I`m a doctor of medicine and specialist in radiation therapy and medical oncology. I have a long time experience of these tumours.
Experience I'm a Doctor of Medicine. Licensed/certified physician and surgeon and specialist in Medical Oncology and Radiation therapy in Sweden, Denmark, Finland, Iceland, Norway and the European Union. Background in Radiation Therapy, Medical Oncology, Radiation Protection, Nuclear Medicine, Diagnostic Radiology, Gynecological Oncology, Clinical Pathology, Clinical Cytology,Hematology and Internal Medicine. M.D. from the faculty of medicine, Royal Karolinska Institute, Stockholm, Sweden. Have also been an exchange student at the Hebrew University, Hadassah Medical School, Jerusalem Israel. Former medical consultant, Swedish National Board of Radiation Protection. Former Police Surgeon and Medical Examiner, Stockholm Police Department. Former Chief Medical Officer, The Royal Guards, The Royal Horse Guards and the Royal Household Brigade, Royal Swedish Army Medical Corps. Now in private practice in Stockholm, Sweden. I also answer questions about Oncology (General Cancer),
General History,
Military History,
Breast Cancer,
Colon Cancer.
Question QUESTION: can a lession of 3.6CMx3.7CMx4.1CM in the brainstem cause
ONLY a little double vision in a 6 yrs girl.
she is a very healthy girl, only a little double vision,absolutly no other sysmptoms
Regards
ANSWER: It may cause double vision but there probably should be other symptoms as well. Please copy her MRI & CT brain scan reports here! You should discuss her case very thoroughly with her neurologist! What kind of lesion is it?
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QUESTION: no other symptoms.
Resultats:
fosse posterieure: presence d’un processus expansif heterogene et infiltrant de 4.1CM d’axe transverse de 3.7CM de hauteur et de 3.1CM d’axe antero-posterieur accupant le tronc cerebral avec un aspect exophytique de la calotte protuberantielle nottament en para-sagital gauche encastrant le tronc basilaire qui reste permeable. Cette lesion ne semble pas s’etendre vers les pedoncules cerebelleux moyens ni superieurs. Absence d’extension mesencephalique identifialble. La masse deforme et aplatie le plancher du quatrieme ventricule sans dilatation de l’aqueduc de silvius. Une prise de contraste ovalaire irreguliere de 1.3x1CM est visible dans la partie anterieure et lateral gauche de ce processus. La prise de contraste parait en cocarde irreguliere et pourrait comporter des residus hemorragiques en hyposignal sur les sequences T2 s’accentuant sur les sequences en diffusion protonique. Une invagination de la masse exophytique est visible en avant de l’olive bulbaire au dessus et en avant de l’abouchement du segment V4 de la vertebrale gauche au tronc basilaire sans engagement des amygdales cerebelleuses dans les trous accipitales. Absence de rehaussement duro-meninge pathologique identifiable par ailleurs.
Etage sus-tentoriel : expansion normale et symetrique des ventricules lateraux sans deplacement des structures medians. Absence d ’anomalie majeure du signal de la substance blanche peri-ventriculaire sous-corticale. Integrite des noyaux gris centraux, du calleva et du revetement cortical. Le sinus sagital superieur et permeable.
Conclusion : L’IRM cerebrale realisee avant et puis après injection du produit de contraste releve la presence d’un large processus expansif et infiltrant du tronc cerebral deformant le quatrieme ventricule sans dilatation des cavites ventriculaire a l’etage sus-tentoriel. La masse comporte une zone de rehaussement heterogene en cocarde irreguliere. L’hypothese d’une lesion neuro-gliale et a soulever en premier
ANSWER: My French is today rather rusty due to very limited use. However after reading the report I can only say that even in the absence of more symptoms - which at present I can not explain - this is a VERY serious case and you MUST discuss it with a neurosurgeon (which I'm not, I'm a medical oncologist & radiation therapist). The position of the tumor will however probably make any surgical intervention at least very tricky. The tumor is most probably too big for radiological treatment with the GammaKnife and conventional radiation can not cure it - certainly not alone. Please do keep me posted!
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QUESTION: Dear,
when we first discover her little double vision,
the examination of her eyes is perfect,am MRI is requested.
the neurologist read the report, and did not believe that
my daughter is healthy and suggest raditherapy.
the oncologist also dit not believe that little double vision is the only sysmptom. when the oncologist see my daughter he say : let do the radiation therapy to reduce the symptom and we will see. what symptoms i ask?, no response.
we start the radiotherapy with 3 week of decadron.
after taking decadron the double vision is very little and
sometimes cannot be seen. after stopping decadron a little
double vision reoccurs.
today i read that the Epidermoid cysts can exist in the brain stem, and decadron alone is excellent if surgery is unavailable.
Epidermoid cysts can be treated with radiotherapy??
can the result of RMI be wrong??
can the RMI itself be wrong??
i am confused, my girl is now in a dance school,
she go for swimming, she play as normal.
many thanks,
Answer Thanks! I do understand your concern! This must be terrible for you! It is normal that the double vision should be reduced by Decadron as that medication will reduce any brain swelling. That is also supported by the fact that more double vision returned after reduction of the Decadron dosage. What is described in her MRI report is NOT an epidermoid cyst. No, epidermoid cysts are not treated with radiation therapy - except if small enough (less than 4 cm) they may be treated with the GammaKnife. In the report it is stated - if I read its French text correctly - that her lesion is an infiltrating process and probably a gliomal process. That does NOT fit with an epidermoid cyst - just as I stated above! It does fit however with a malignant brain tumor. I can not guarantee that the report fits what is actually seen in her MRI scans but I find it very improbable that there should be any mistake there. And if there is no mistake there then this can not be an epidermoid cyst! Please do keep me posted and have a new MRI brain scan done after her treatment!
