Radiology/Lesion

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Hello.  I am a 40 year old healthy female and was told I have a T2 hyperintensity in my right temporal lobe, non specific.  I had an MRI for my neck pain and it was an incidental finding.  It hasn't grown in three years.  I don't have seizures.  Recently followed up and received an opinion from a neurosurgeon and he recommended needle core biopsy.  A couple images are attached that may help.  What is your opinion on what you think this may be based in your neuro radiology experience and and do needle biopsies spread cancer cells, if that is indeed what this is?  The only symptoms I have are occasional stabbing pains in right temporal lobe (very rare), sometimes headaches, and a strange tingling in my left cheek that only happens sporadically when I touch it to rub lotion on it mostly.  Thank you.

Answer
Cindy,

needle biopsy does not spread cancer cells for the brain lesions.  The spot is indeed non specific.  It may represent several things. I am not sure what your official report says.  It's stability over three years doesn't really help much.   Could it be a very low grade tumor...perhaps...and I would not expect it to change much.  Could it be a non specific scarring from a prior event - yes.  It can be related to something called focal cortical dysplasia although i think it is less likely since some of the margins on the second image are fairly sharp.  I had a variety of lesions like these that were left alone and just followed or biopsied.   While the procedure is invasive it is not a large surgery, however, carries risks associated with anesthesia and certainly where this lesion is which is deep. If you can live with the above possibilities and get an MRI every year to two years as a follow up then perhaps it is an option.  If you must know what it is, and if it is a tumor (although it would be a low grade tumor like grade 2 astrocytoma) then I guess a biopsy is something to consider.  I am not sure that your symptoms are related to this lesions.

Hope this helps.

Michael  

Radiology

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Michael K.

Expertise

Almost any kind of questions regarding any types of radiology exams, procedures, meaning of radiology reports etc...

Experience

12 year experience in the field of radiology

Organizations
American Society of Neuroradiology, Senior Member Society of Pediatric Radiology, Active Member

Publications
Radiology Seminars in pediatric neurology American Journal of Roentgenology American Journal of Neuroradiology

Education/Credentials
Board Certified in Diagnostic Radiology Additional Certificate of Qualification in Neuroradiology

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