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Brain Tumors/Superior tectum lesion

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Expert: - 8/16/2009


Question

FlairT2 Image 1
Dear Dr. Claes-Gustaf Nordquist,

I am a relatively young(38)female and after an escalation in neurological symptoms(ans dysfunction,visual,vertigo,ataxia,and falling),my current neurologist ordered a T3 MRI w/ & w/o contrast.That scan found this: "a rounded focus of signal abnormality abutting the dorsal aspect of the superior tectum." "The lesion is hypointense on T1/T2 but hyperintense on FLAIR and demonstrates enhancement following administration of contrast." My current doc wants to wait a year then scan again but readily admits that because it is in the brainstem, there isn't anything that can be done and says he believes it is slow-growing or benign. I really am not comfortable waiting a year when they don't know what it is. I have enclosed my T2FLAIR image for your review. Do you have any suggestions and should I go to John Hopkins(which is relatively close-by for another opinion.)  

Thank you very much in advance.

Heather

Answer
If I happened to be in your shoes I would DEMAND a second opinion. Yes any lesion like this in the brainstem is not treatable surgically. I'm not sure it can be treated successfully radiologically (not surgically) with the GammaKnife. That too may be impossible - you must discuss that with a neurosurgeon - but from a stand point of physics it could be treated that way and your lesion SEEMS small enough for that method (how big in cm is it precisely?). That is unfortunately the only advice I can give you!

Claes-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 and specialist in Medical Oncology and Radiation Therapy, educated and trained in Sweden. Now retired. 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. You can also reach me on: http://www.lifestylerescue.com/expert/health-fitness-advice/dr-claes-gustaf/128 . I have no restrictions on the number of questions there. I also answer questions about Oncology (General Cancer), General History, Military History, Breast Cancer, Colon Cancer.

Education/Credentials
Doctor of medicine, specialist in medical oncology & radiation therapy.

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