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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Headache, Blurred Vision, Vertigo. MRI Shows Extra Axial Mass. Suggestion?

Sir, I have had severe headaches for 6+ weeks with blurred vision and vertigo. MRI impression suggest the following;
1. Extra-axial mass in the left occipital region with enhancement pattern and signal characterists most consistent with meningioma. The differential diagnosis may also include metastatic lesion.
2. Heterogeneous bone marrow signal of the frontal love with questionable enhancement. Bone scan is recommended to exclude any likelihood of Osseous mete static lesions .

Whiole body bone scan run.results of which will be available today.
But with what information is available what does this suggest to you.?
I have meet with a Neurosurgeon and he says many things. Will try to include here;
1. Size is 2..3 cm x 1.7 cm x 1 cm
2. Says it is most likely binign
3. Slow growing
4. Feels I have had it some time
MRI if 5 years ago does not reflect this existence. He personally feels they missed it
5. Some symptoms are not consistent with this type lesion. Namely, blurred vision, vertigo , taste have been affected, and severe pain. Suggests there other reason for this
6 suggests just to watch it for. 6 months having. MRI then repeated. Consequently reevaluating at that time.
7. Says it is operable, but would not be without some risks. Not in attachment, but in vessels located in the area of mass.

I have also had x-ray studies of my right lower leg done due to nonspecific pain. Of a 9. Not related to a knee injury of the same side. Knee was infected after a fall. Much fluid drained (300+ cc) done three times. No organisms isolated in culture. Diagnosis suggest osteoarthritis. Knee has no cartilage.
Other areas if significance; numerous area of sibnificant discomfort. I say discomfort because the pain is chronic and not a cute. Areas are upper legs upon sitting. Back between my shoulder blades and lower back, hips, left foot. These areas are of consistent discomfort . Areas if transient pain are hands and elbows.

What might your impression be and your suggestion
Wed, 17 Jul 2013
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Neurologist 's  Response
Hi,
Thank you for posting your query.
I must say your neurosurgeon has done a great job, and has perfectly explained most of the issues here. I would agree with him on most of the issues.
Meningioma is a benign tumor, and can be treated well with surgery. If it is growing in size, as evidenced from a repeat MRI, then, the surgery can be done.
Please get back if you require any additional information.

Best wishes,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)
Senior Consultant Neurologist
Apollo Hospitals, Hyderabad,
My personal URL on this website: http://bit.ly/Dr-Sudhir-kumar
My email: drsudhirkumar@yahoo.com
My blog: http://bestneurodoctor.blogspot.com/
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Have Headache, Blurred Vision, Vertigo. MRI Shows Extra Axial Mass. Suggestion?

Hi, Thank you for posting your query. I must say your neurosurgeon has done a great job, and has perfectly explained most of the issues here. I would agree with him on most of the issues. Meningioma is a benign tumor, and can be treated well with surgery. If it is growing in size, as evidenced from a repeat MRI, then, the surgery can be done. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website: http://bit.ly/Dr-Sudhir-kumar My email: drsudhirkumar@yahoo.com My blog: http://bestneurodoctor.blogspot.com/