Expert: Claes-Gustaf Nordquist, M.D. - 9/6/2010

Question
my father is 56..he is having weakness in right foot..mild
weakness in rgt hand and mild facial droop on rgt side...mri
contrast and spectroscopy was done...it shows mass lesion in
left basal ganglia with sparing of caudate nucleus..the mass
is seen inferiorly extending into left medial temporal
lobe...another lobulation in left thalamus with extension
into left cerebral peduncle..lesion hyperintense on t2 and
flair  and shows  subtle post contrastb enhancement..the
thalamic componenet appears more hyperintense...mass
measures 28.6mm 36.1mm 40.0 mm {cc}
spectroscopy shows choline peak...finding suggest
glioma..low to high grade... this tumour is inoperable...and
biopsy itself carries some risk...should we wait for smtime
as he is functionally well preserved and get repeat mri
after some time or can v go directly to
radiotherapy/chemo...pl help  

Answer
Well the size of his tumour is right on the border of being too big for stereotactic radiation therapy with the so called GammaKnife. If possible such treatment can delete the tumour without surgery. But as I mentioned it is on the borderline of being too big for such treatment. I know there is a GammaKnife in New Delhi. Contact them and discuss his case. Apart from that (or even in combination with it) only radiation therapy (conventional) & chemotherapy can be recommended. I see no reason to wait with such treatments in this situation. But unfortunately they can not offer any real cure only a delay in the process. Not even surgery or anything else can at present offer any guarantee of a cure unfortunately.





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