Expert: Claes-Gustaf Nordquist, M.D. - 2/1/2010

Question
Dear Sir/Madam,


C.T. SCAN of a patient suffering from severe head ache has been got conducted. Examination report of the C.T. SCAN is as follows:-

Mr. Trilok Singh
AGED 35 Years
Sex : Male

PLAN AND CECT HEAD

POST FOSSA

The 4th ventricle is in the midline.
The cerebellar parencyma is normal
The region of the brain stem is normal

SUPA TENTORIAL

An iso dense mass lesion, showing inteense enhancement with contrast and with a small area of low attenuation in it is seen in the right frontal region in relation to the right side of the frontal bone.

The mass measure approximately 3.9x3.6 cms in maximum cross sectional diameter. There is marked surrounding oedema. Marked effacement of the 3rd Ventricle, the right lateral ventricle are slightly dilated.

A shift of the midline septum to the left is noted.

OPINION : CT Findings are suggestive of a neoplastic mass lesion (likely a meningioma) in the right frontal region. Please correlate clinically.

Operation of excision of the meningioma has been advised.

QUERY

I want to know what after effects of the operation in this case can be expected. Whether risk to the life of the patient can also be expected in this case. Preoperative clinical status of the patient is all right. All blood tests, ECG. BP, chest X-ray are O.K.

Pls advise and suggest.


Best Regards

Answer
This CT scan shows a tumor - probably a meningioma, which usually is a benign lesion - close to the right side of the frontal part of the brain. It is so big that it is on the border of being treatable radiologically with the so called "GammaKnife" or with proton beams. I will therefore NOT recommend such treatment! It is also so big that it pushes midline structures to the left. Based on this it is clear that treatment is necessary and the only remaining method of treatment is surgery. Surgery is therefore most probably necessary - as has already been recommended. However I'm NOT a neurosurgeon. I'm a medical oncologist and radiation therapist with experience of treating brain tumors. I therefore recommend that you direct this question to an expert of neurosurgery or maybe neurology.  I also recommend that an MRI brain scan is done to clarify the situation further! Good luck!


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