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What Does My Brain MRI Scan Report Indicate?
Question: ;I have a relative with paraplegia 5 years ago. Now developed more weakness left side 3 months ago. MRI brain showed 5.5×4×6 wedge shaped lesion right temporoparietal region. Hypo intense on T1WI, hyperintebseon on T2WI with small focus of enhancement after iv contrast suggesting lesion surrounded by wide zone of edema. Enhancing component measuring 2.5×1.5cm & 0.9×0.8 cm.
Mass involving right sided basal ganglia, thalamus, internal capsule, external capofsule and insular region. There is inferior extension in to right temporal lobe only sparing a rim of cortex medial ly it is reaching sub ventricular parenchyma. Inferomedial extension of lesion is towards brain stem including right crus of mid brain and upper cons. There is mass effect causing some compression over ipsilateral lateral ventricle and efface ment of third ventricle. Predominantly mass is confined to right cerebrum and brain stem , however some infiltration of genu of contralateral corpus callosum & periventricular white matter is seen also. Cerebellum not involved. 7th & 8th nerve complexes normal. No tonsillar herniation seen.
Impression lymphoid mass, slow growing glioma. Inflammatory and is chemical causes less likely.
Could you please tell me your opinion after reviewing this report
Do you think this tumor us operable & prognosis.
Treatment options?
Thank you
Mass involving right sided basal ganglia, thalamus, internal capsule, external capofsule and insular region. There is inferior extension in to right temporal lobe only sparing a rim of cortex medial ly it is reaching sub ventricular parenchyma. Inferomedial extension of lesion is towards brain stem including right crus of mid brain and upper cons. There is mass effect causing some compression over ipsilateral lateral ventricle and efface ment of third ventricle. Predominantly mass is confined to right cerebrum and brain stem , however some infiltration of genu of contralateral corpus callosum & periventricular white matter is seen also. Cerebellum not involved. 7th & 8th nerve complexes normal. No tonsillar herniation seen.
Impression lymphoid mass, slow growing glioma. Inflammatory and is chemical causes less likely.
Could you please tell me your opinion after reviewing this report
Do you think this tumor us operable & prognosis.
Treatment options?
Thank you
Brief Answer:
A biopsy may be needed first.
Detailed Answer:
I read your question carefully and I understand your concern.
Considering that report, the mass which has been found is most probably a tumor. Two types of tumors are most probable either a lymphoma (a tumor derived from the lymph cells) or a low grade glioma (a tumor deriving from the glia, the cells which form the support for the neurons).
Before considering surgery first the type of tumor has to be precised, because if it is a lymphoma then surgery is of no value. Surgery would be an option only if it is a glioma. Even if it is a glioma I do not think surgery can evacuate the whole tumor because of its deep location, involving the midbrain and pons, which constitute the brainstem where many vital structures are situated, surgery would cause more damage than benefit. So probably if will be chemotherapy which will be the mainstay of treatment, and it may or not be associated with radiotherapy.
The first step though as I said will be determining exactly the nature of the mass, for that probably a biopsy will be necessary, for which a surgical procedure will be needed.
As for prognosis it varies on the result of the biopsy, if lymphoma chemotherapy can prolong life significantly as it responds well to chemo at least at first, and median survival is about 4 years if in good general health. For gliomas it is a little difficult as knowing the grade is vital for evaluation, if low grade can also achieve good results with chemotherapy, high grade ones have a limited survival.
I remain at your disposal for other questions.
A biopsy may be needed first.
Detailed Answer:
I read your question carefully and I understand your concern.
Considering that report, the mass which has been found is most probably a tumor. Two types of tumors are most probable either a lymphoma (a tumor derived from the lymph cells) or a low grade glioma (a tumor deriving from the glia, the cells which form the support for the neurons).
Before considering surgery first the type of tumor has to be precised, because if it is a lymphoma then surgery is of no value. Surgery would be an option only if it is a glioma. Even if it is a glioma I do not think surgery can evacuate the whole tumor because of its deep location, involving the midbrain and pons, which constitute the brainstem where many vital structures are situated, surgery would cause more damage than benefit. So probably if will be chemotherapy which will be the mainstay of treatment, and it may or not be associated with radiotherapy.
The first step though as I said will be determining exactly the nature of the mass, for that probably a biopsy will be necessary, for which a surgical procedure will be needed.
As for prognosis it varies on the result of the biopsy, if lymphoma chemotherapy can prolong life significantly as it responds well to chemo at least at first, and median survival is about 4 years if in good general health. For gliomas it is a little difficult as knowing the grade is vital for evaluation, if low grade can also achieve good results with chemotherapy, high grade ones have a limited survival.
I remain at your disposal for other questions.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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