Expert: Claes-Gustaf Nordquist, M.D. - 1/23/2010

Question
QUESTION: My daughter who is 4 has Astrocytoma, 80% was removed from the spinal cord the rest was to close to nerves to remove, she finished chemo 6 months ago and was told that the tumor was dead, she then had pressure build up and had a shunt placed this November. She also had MRI and spinal tap in Nov and both came back neg. She started having leg pain last weekend and was taken to hospital and received another MRI the finding were that the tumor had spread from T-12 to the brain stem and lower part of brain, they told us she has a 50% chance to live another year and 20% chance to make it 2 years, they started her on radiation yesterday and will continue that 5 days a week for 6 weeks but say its only to help with pain, she is currently at Riley Childrens Hospital. Are there any experimental treatments or any other advice or treatments that you offer?

ANSWER: Unfortunately in this situation I'm not aware of anything anywhere that can with any certainty help your daughter. How big is her tumor relapse?


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---------- FOLLOW-UP ----------

QUESTION: They have not mentioned the size just where it has spread, at this time we were told they can't be 100% that its high grade. But because they have not seen a low grade spread this fast so are assuming it is. Thing that is mostly upsetting is that she is really having no effects from it. She still acts the same up playing and eating and doing a normal routine. If it is high grade even with the radiation about how long will it take to start having an affect on her?

ANSWER: Since she has had surgery done I have to assume that her tumor has been checked by a pathologist.  What does her pathology report say? I do need to know that to be able to answer. You can copy it here.




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---------- FOLLOW-UP ----------

QUESTION: This is the report we were given.
She had an MRI of the spine and head. The results of spine were 1)Interval cephahad and caudal progression of the diffuse expansile heterogeneous cervicothoracic cord from C3 TO C4 midlevel to mid T11. 2) Interval marked progression of the disseminated leptomeningioma metastases throughout the spine with clumping of the nerve roots. For the MRI of the head. 1) interval marked progression in the leptomeningioma carcinomatosis with minor nodule leptomeningeal lessions now appearing more conglomerate and disseminated.2) Diffuse enhancement along the seventh and eighth and hypoglossal nerve, likely part of the leptomeningeal metastases. 3) Non0Visual if the the trigeminal nerve, likely encased within the leptomeningeal metastases. 4) Major visualized intercranial, flow voids are intact.5)Stable left parietal ventriculostomy cather with like ventricles.  

Answer
Oh I see! So this is actually not an astrocytoma at all but a malignant meningioma (which is unusual) that has spread widely within her head and spine. I'm sorry that in this situation I have nothing new to offer. I'm very sorry that I have nothing better to tell you!


You can also reach me on: http://www.lifestylerescue.com/expert/health-fitness-advice/dr-claes-gustaf/128     There is no restriction to the number of questions there.