Expert: Claes-Gustaf Nordquist, M.D. - 8/8/2010

Question
Hi,

My mother had a ct scan the day before. It reads a well defined rounded hyperdense extraaxial mass measuring 3.1X2.3X1.9 is seen in the region of left high parietal parafalcine region and extending into right as well. A tiny calcification is seen within it. On postcontrast study intense enhancement is seen.
Rest of cerebral parenchyma appears normal in morphology.
Lateral ventricles are prominent. There is no mid line shift. Brainstem and cerebellum  appears unremarakble.

Impression:

CT Studyis suggestive of -
A meningioma measuring 3.1X2.3X1.9cm in th region of left high parietal parafalcine region and extending into right as well.


Could you please let me assess the seriousness of the report and is it cancerous in nature?What does calcification suggest?

Pateint Age: 53
Sex: Female
Place: India

Answer
This is probably a meningioma - a tumor originating in the outer lining of the brain not the brain itself. It is usually not cancerous. It is located inside her skull close to its top above her brain and near the midline running from front to back of her skull mainly to the left of it but extending slightly to the right of it as well. Along the front to back axis it is located behind the frontal part of the brain close to the parietal lobes. This is still within the "forward" part of her brain. It is 3.1x2.3x1.9 cm in size (1 inch = 2.54 cm). The calcification is not really significant. Treatment is NECESSARY. Even if not cancerous such tumours grow! That is NOT good for her brain! The inside of her skull MUST mainly be regarded as a closed space with a limited volume. So any growing process inside it has consequences for the rest of what is inside it (= her brain). I therefore recommend urgent treatment. That can either be surgical or it can be radiological using the so called GammaKnife - in that case a treatment completely without surgery. The size of her lesion is not too big for such radiological treatment. Both methods are about equally good for a case like this. But treated with either of them it SHOULD be! She has a very good chance of being cured with either method! Good luck!



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