SoulFrost
04-11-2001, 10:15 PM
A relative of mine has recently been diagnosed with "something" growing in his brain. Originally, it was thought to be possibly a calcium deposit, but evidently, that has been ruled out.
These are the MRI results. If I'm reading this correctly, these are the two main candidates for what it could be...but I'm unsure of exactly what it all means.
Of course, the results will be interpreted by a professional in a couple of days--but if someone could explain this, it would help his family and friends move past the "we just have to wait" stage.
MRI of the brain with and without Omniscan
Technique:
T2 weighted fast-spin echo sagittal and axial images are submitted, as well as a FLAIR coronal sequence. Additionally, a T1 weighted spin echo axial sequence is obtained. After the administration of a 16 cc Omniscan, T1 weighted echo axial images are acquired. The study was performed on the Marconi 0.23 Tesla proview open magnet.
Findings:
There is an enhancing mass in the posterior aspect of the right lateral ventrical. The mass measures 1.5 cm in width and 1.9 cm in length, anterior to posterior. The mass does appear to contain some calcification, although this might be better detected on CT. There is heterogeneous but predominatly intermediate intensity on T2 while it is predominatly isointense on T1. Enhancement is moderate. The mass does not appear to be aggressive. The most likely diagnosis is ependymoma, subependymoma, or neurocytoma. Also to consider in the differential diagnosis would be chorid plexus papilloma and carcinoma, meningioma, astrocyloma, hemangioma, and xanthogranuloma.
There is no evidence of ventricular dilatation. Ventricals and basil cisterns are otherwise unremarkable. Midline structures are normal, and there is no evidence of midline shift.
There are no other signs of intracranial mass or abnormal fluid collection. Normal signal void is seen in the internal carotid and basilar arteries. There is no evidence of abnormality within the mastoid air cells. There is minimal increased signal intensity within the posterior maxillary sinuses consistant with mild sinusitis.
Impression:
1.9 X 1.5 cm right Choriod Plexus mass. Suspect most likely an ependymoma or neurocytoma. Differential diagnosis provided above.
and
NEUROCYTOMA, CENTRAL
This rare, grade I, benign tumor typically occurs in a lateral ventricle in the region of the foramen of Monro, and occasionally extends into the third ventricle as well. It is supplied by many blood vessels. The central neurocytoma shows mature cells, similar to normal neurons of the gray matter, although their cell of origin is unknown. It is most common in young adult males. Symptoms are those associated with increased intracranial pressure: headache, nausea and vomiting, drowsiness, vision problems and mental changes.
Standard treatment is surgery, which is often successful. Excessive bleeding can limit the extent of tumor removal however. The routine use of radiation therapy as an adjuvant therapy is still under discussion.
EPENDYMOMA
An ependymoma arises from the ependymal cells that line the ventricles and central canal of the spinal cord. Ependymomas represent about 6% of all gliomas, and 10% of all childhood brain tumors. About 65% of ependymomas occur in the posterior fossa, the lower back portion of the brain. The remainder are found higher in the brain or in the spinal cord. Ependymomas are more common in children, but they also occur in adults.
About 10% of these tumors, particularly those of higher grade, spread via the cerebrospinal fluid (CSF). A spinal MRI with gadolinium enhancement can often detect if spread has occurred. A spinal tap is performed to test the CSF for the presence of tumor cells.
There are two types of grade I, benign ependymomas: myxopapillary ependymoma
commonly found in the spine; and subependymoma. The subependymoma most often arises in the 4th ventricle; the second most frequent location is one of the lateral ventricles. The grade I tumors might be treated by surgery alone if the tumor is totally removed. Radiation therapy may be recommended following surgery if any tumor remains. The papillary, cellular, and clear cell ependymomas are grade II tumors. These tumors are most frequently located in the fourth ventricle and the midline area. The extremely rare papillary ependymoma is located in the cerebellopontine angle. Anaplastic ependymoma is the grade III, malignant form of this tumor, and its typical location is the cerebral hemispheres.
The rare ependymoblastoma, a high-grade, grade IV tumor, is more common in children and is classified as a PNET (primitive neuroectodermal tumor) in some systems.
An ependymoma can also be classified as "low-risk" or "high-risk," based on the location of the tumor and if tumor cells are found in the cerebrospinal fluid. Tumors in the fourth ventricle and midline are often more difficult for the neurosurgeon to access than those located in the cerebral ventricles.
The usual treatment for the higher grade tumors is surgery followed by radiation therapy to the brain and spinal cord. A shunt is often necessary to relieve the increased intracranial pressure that frequently accompanies this tumor. Chemotherapy or a form of local radiation might be used for recurrent tumors. Clinical trials using chemotherapy for initial treatment along with surgery and radiation are available. In very young children (under the age of three), chemotherapy might be used to delay radiation.
Forgive any spelling errors--I hand-copied this from scanned bitmaps of the original docs.
Thanks!
David
These are the MRI results. If I'm reading this correctly, these are the two main candidates for what it could be...but I'm unsure of exactly what it all means.
Of course, the results will be interpreted by a professional in a couple of days--but if someone could explain this, it would help his family and friends move past the "we just have to wait" stage.
MRI of the brain with and without Omniscan
Technique:
T2 weighted fast-spin echo sagittal and axial images are submitted, as well as a FLAIR coronal sequence. Additionally, a T1 weighted spin echo axial sequence is obtained. After the administration of a 16 cc Omniscan, T1 weighted echo axial images are acquired. The study was performed on the Marconi 0.23 Tesla proview open magnet.
Findings:
There is an enhancing mass in the posterior aspect of the right lateral ventrical. The mass measures 1.5 cm in width and 1.9 cm in length, anterior to posterior. The mass does appear to contain some calcification, although this might be better detected on CT. There is heterogeneous but predominatly intermediate intensity on T2 while it is predominatly isointense on T1. Enhancement is moderate. The mass does not appear to be aggressive. The most likely diagnosis is ependymoma, subependymoma, or neurocytoma. Also to consider in the differential diagnosis would be chorid plexus papilloma and carcinoma, meningioma, astrocyloma, hemangioma, and xanthogranuloma.
There is no evidence of ventricular dilatation. Ventricals and basil cisterns are otherwise unremarkable. Midline structures are normal, and there is no evidence of midline shift.
There are no other signs of intracranial mass or abnormal fluid collection. Normal signal void is seen in the internal carotid and basilar arteries. There is no evidence of abnormality within the mastoid air cells. There is minimal increased signal intensity within the posterior maxillary sinuses consistant with mild sinusitis.
Impression:
1.9 X 1.5 cm right Choriod Plexus mass. Suspect most likely an ependymoma or neurocytoma. Differential diagnosis provided above.
and
NEUROCYTOMA, CENTRAL
This rare, grade I, benign tumor typically occurs in a lateral ventricle in the region of the foramen of Monro, and occasionally extends into the third ventricle as well. It is supplied by many blood vessels. The central neurocytoma shows mature cells, similar to normal neurons of the gray matter, although their cell of origin is unknown. It is most common in young adult males. Symptoms are those associated with increased intracranial pressure: headache, nausea and vomiting, drowsiness, vision problems and mental changes.
Standard treatment is surgery, which is often successful. Excessive bleeding can limit the extent of tumor removal however. The routine use of radiation therapy as an adjuvant therapy is still under discussion.
EPENDYMOMA
An ependymoma arises from the ependymal cells that line the ventricles and central canal of the spinal cord. Ependymomas represent about 6% of all gliomas, and 10% of all childhood brain tumors. About 65% of ependymomas occur in the posterior fossa, the lower back portion of the brain. The remainder are found higher in the brain or in the spinal cord. Ependymomas are more common in children, but they also occur in adults.
About 10% of these tumors, particularly those of higher grade, spread via the cerebrospinal fluid (CSF). A spinal MRI with gadolinium enhancement can often detect if spread has occurred. A spinal tap is performed to test the CSF for the presence of tumor cells.
There are two types of grade I, benign ependymomas: myxopapillary ependymoma
commonly found in the spine; and subependymoma. The subependymoma most often arises in the 4th ventricle; the second most frequent location is one of the lateral ventricles. The grade I tumors might be treated by surgery alone if the tumor is totally removed. Radiation therapy may be recommended following surgery if any tumor remains. The papillary, cellular, and clear cell ependymomas are grade II tumors. These tumors are most frequently located in the fourth ventricle and the midline area. The extremely rare papillary ependymoma is located in the cerebellopontine angle. Anaplastic ependymoma is the grade III, malignant form of this tumor, and its typical location is the cerebral hemispheres.
The rare ependymoblastoma, a high-grade, grade IV tumor, is more common in children and is classified as a PNET (primitive neuroectodermal tumor) in some systems.
An ependymoma can also be classified as "low-risk" or "high-risk," based on the location of the tumor and if tumor cells are found in the cerebrospinal fluid. Tumors in the fourth ventricle and midline are often more difficult for the neurosurgeon to access than those located in the cerebral ventricles.
The usual treatment for the higher grade tumors is surgery followed by radiation therapy to the brain and spinal cord. A shunt is often necessary to relieve the increased intracranial pressure that frequently accompanies this tumor. Chemotherapy or a form of local radiation might be used for recurrent tumors. Clinical trials using chemotherapy for initial treatment along with surgery and radiation are available. In very young children (under the age of three), chemotherapy might be used to delay radiation.
Forgive any spelling errors--I hand-copied this from scanned bitmaps of the original docs.
Thanks!
David