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How can tumor cells in the spinal fluid be diagnosed ?

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General & Family Physician
Practicing since : 2003
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My 7 year daughter has medulloblastoma and it's removed by surgical process completely. The biopsy report not mentioned the Grade of tumor. Physician recommended for craniospinal radio therapy. Doctor suspecting that the tumor cells spread to spinal fluid. How can we diagnose the presence of tumor cells in the spinal fluid ? MRI or PET CT, which is better ? Please get me a reply.
Suresh K G
Posted Sat, 28 Apr 2012 in Brain and Spine
Answered by Dr. Deepak Anvekar 40 minutes later
Thanks for the query.

The best way to diagnose the presence of tumor cells in the spinal fluid, is to do a Cerebro-spinal fluid (CSF) cytology analysis. This Fluid is obtained by a lumbar puncture, where in a very thin needle is inserted into the spinal canal and fluid is obtained for testing.

A lumbar puncture for CSF analysis is usually done by a experienced doctor ( General physician, Neurologist, or a Anesthetist) under local anesthesia, under strict aseptic conditions.

MRI or PET-CT are imaging studies that detect the gross anatomical lesions, They are not useful to detect the presence of the tumor cells within the CSF as the cell size is in microns and cannot be visible on the imaging procedures.

With respect to follow up procedures following the surgery, here are a few things that might help you.

Since the surgery, has been done recently, radiotherapy will be initiated soon. The need for chemotherapy and the indication will also be considered based on the size and specific location of the tumor.

Standard therapy for medulloblastoma consists of aggressive surgery followed by radiation to the entire craniospinal axis and with or without adjuvant chemotherapy.

Careful monitoring of response and treatment-associated side effects is performed weekly during radiotherapy and at least every 2 weeks during chemotherapy.

Following the completion of therapy, assessments are conducted every 3 months for the first 12-18 months, every 6 months for the next 2 years, and then annually, provided no complications have occurred.

Such assessments might include a MRI, depending on the physical examination findings.

I hope this helps to answer your questions effectively.

Please feel free to forward any additional queries, which I will be glad to answer.

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