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What Does " Post Radio Therapy Of A Recurrent Meningioma" On An MRI Scan Indicate?

Posted on Sat, 20 Dec 2014

Question: Hi Drs.

can anyone describe what exactly this MRI brain with contrast scan says, its post radio therapy of a recurrent meningioma.

Thanks,
XXXX

Answered by Dr. Indu Kumar (37 minutes later)

Brief Answer:
It may be recurrent meningioma.

Detailed Answer:
Hello XXXXXXX

MRI findings indicate post operative changes in left fronto-parietal region of brain.Post operative changes are in the form of gliosis.
Gliosis is normally seen in post-operative region.

There is a plaque like enhancement(7.8 x 1.5 cm) in the mentioned area of brain along the convexity,it may be left over tumour or recurrent meningioma.
It is important to compare from previous images.If there in increase in size then it may be considered as recurrent meningioma.

There is also mild to moderate dilatation of ventricles.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indu Kumar (56 minutes later)

Thanks for your prompt response Dr.

I would like to give you an patient's meningioma history.

My mom aged 46 years has undergone Craniotomy surgery twice within 18 months duration. First one on Aug'12 and the second one on May'14.

In the first Biopsy, tumor is recognised as WHO Grade-I Meningioma.

In Second Biopsy, tumor is recognised as WHO Grade-II Atypical Meningioma.

On observing the upgrading(from Grade-I to Grade-II) tumor within short span, Doctor suggested to go for Radiotherapy. So one of the Radiation Oncologist prescribed us to go for RapidArc Radiotherapy. Mom has underwent all the 30 doses of the RT session(June'14).

1. Can you please describe what gliosis is.
2. I have attached another report(2 months older from now), can you please confirm whether its a residue or a recurrent tumor.
3. If its a recurrent tumor, what are the steps to be followed as a precautionary measures.

Thanks,
XXXX

Answered by Dr. Indu Kumar (4 hours later)

Brief Answer:
Gliosis is due to repair mechanism in brain.

Detailed Answer:
Hello XXXXXXX

Gliosis is due to repair mechanism in brain.Any injury to brain tissue heals by gliosis.

Your mother's report indicate chances of recurrence of meningioma.There is rapid increase in size of the lesion.

There is no specific precautionary measure as such which can control its aggressiveness.Radiotherapy,Chemotherapy are the options.It can be discussed with oncologist.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indu Kumar (38 minutes later)

Thanks for your brief response.

I agree to your answers, but Radiotherapy is already done. What could be the next possible treatment to slowdown its growth and also can you please give me an overview on RapidArc radiotherapy and how is it different from latest Brachy RT.

Thanks,
XXXX

Answered by Dr. Indu Kumar (51 minutes later)

Brief Answer:
Brachy RT is more appropriate for your mother.

Detailed Answer:
Hello XXXXXXX

Brachy RT is more appropriate for your mother.It is generally advised in patients with recurrent tumour who had already underwent radiotherapy sessions and not able to tolerate external radiation.
In brachy RT,implants are placed inside the tumour and it delivers radiation to tumour cells only.There is no damage to healthy tissues.It also causes more concentrated delivery of radiation to the area where cancer is most likely to recur.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indu Kumar (6 hours later)

Thanks for the response Dr.

Just want to know will there be any impact on patient if the RT is done more than once.

Thanks,
XXXX

Answered by Dr. Indu Kumar (7 minutes later)

Brief Answer:
RT can be given more than once.

Detailed Answer:
Hello XXXXXXX

RT can be given more than once.Patient may have general side effects like hair loss,scalp irritation, muffled hearing etc.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Prasad