Expert: Claes-Gustaf Nordquist, M.D. - 5/11/2011

Question
My husband was diagnosed with a LGG-a primary tumor on his front right said of his brain. He had a craniotomy a little over a week ago. He is 46, otherwise completely healthy - was non-symptomatic until a seizure almost 2 weeks ago. Biopsy removed 5% of the mass for the pathologist but said it was too widespread and mostly 'normal' to try to remove more. He is recovering well so far and I am wondering if I need to be concerned with his mortality as related to this diagnosis. I've read that his prognosis is better than it would be had he been at a higher grade, his is rated as a 1, but just not sure what that means and what his future holds. Said it is a slow growing, non-aggressive mass and he is soon to be begin 30 radiation sessions. I know this affects everyone differently and NO ONE can predict some things, but from a medical history standpoint, will this shorten his life substantially? Thank you kindly for sharing your knowledge.
Regards,
Shay

Answer
Malignant brain tumors are graded based on the microscopic tumor tissue architecture they present. This microscopic picture correlates rather well with how (much) malignant such a tumor is. And the grade of malignancy correlates well with the prognosis. Usually the grade is from 1 to 4 where 1 is the lowest grade of malignancy and 4 the highest. A high grade tumor like a grade 4 usually has a very bad prognosis with a short survival time (around one year or so) while a grade 1 usually can live for many years. But to evaluate grade is NOT an easy task and requires a VERY experienced and talented neuropathologist or even a team of such pathologists that reach a conclusion as a team work. So there is always a certain uncertainty with regards to a grade evaluation and how accurate it is. However it is probable or at least possible that your husband can live with this for many years but of course I can not give you any guarantees. How big is his tumor? If small enough (around one inch in size) it may be possible to eradicate it radiologically without any surgery by the use of stereotactic radiation therapy (by the GammaKnife or proton beams). If too big though only conventional radiation therapy remains as a possibility. That however can not cure him only prolong survival. Thanks!





You can also reach me at: http://www.liveperson.com/professional/expert-profile.aspx?gsBMQvSJ0S4K1haAm6AtH
There is no limit to the number of questions there. Please note: NEW SITE!