Dark center in AN on pre-op MRI

[captoats]

Just got the disc with my pre-op MRI with and without contrast and had a question for the armature radiologists on the board.  Waiting for a call from the surgeon for his take on this.  My right side AN is about 1.4 X 1.7 CM.  On the images with contrast, the center of the tumor is dark.  I have been reading about how a tumor gets a dark center after radiation and wondered if that could indicate this thing is dying on its own or is it normal for these things to have a dark center.  My diagnosis MRI about 2 months ago was done  without contrast (at my request) so its hard to compare images. 

I haven't had radiation or any other treatment for the AN yet but have been taking Zyflamend for a couple of months since diagnosis.  Started taking Zyflamend to see if it would help with a dull ear ache in the AN side that my ENT thought was related to the AN and, amazingly, it worked!  Tried a few over the counter meds before Zyflamend but nothing did a thing for the pain.  Someone on the board mentioned this stuff and thought I'd give it a shot.  If by some miracle this thing is shrinking or dying on its own or with help from who knows what, I might stand down on the surgery for a while and watch it.   

[Jim Scott]

Captoats ~

With the usual disclaimer that we're not doctors I'll venture to state that, tempting as it is, I wouldn't allow myself to get too excited over the recent MRI results until your doctor has analyzed them and spoken to you.  Usually, the radiologist will write a report on the 'findings' of the MRI.  Because the MRI isn't a perfect 'photo' the dark spot could be normal - or an indication of spontaneous necrosis, which is rare but not unknown.  The conventional wisdom is that no medicine will affect an acoustic neuroma but again, I'm not a physician or scientist and I won't claim to know (a) if your AN has actually experienced spontaneous necrosis and, (b) if that has occurred, whether the Zyflamend played any part in it.  

In any case, I hope you're one of the fortunate few to have spontaneous necrosis occur- and I look forward to learning what the radiologist's report states.  Please let us know.  Thanks.

Jim

[captoats]

Jim,
Thanks for your thoughts on this. I am awaiting the report and will post what the guy in the white coat has to say about the dark center.  Not expecting a get out of jail free card but if one came my way, I'd take it! I have had minimal symptoms (slight ringing and minor high frequency loss, the classics, I suppose) but the ear ache thing is what got me to the MRI and the diagnosis in the first place.  Kind of a dull deep ache that persisted for a few weeks.  Two ENT's suspected the AN was the cause and now that pain is totally gone since I've been taking the Zyflamend.  I'd love to watch and wait but if the thing grows, it seems the chance of saving my hearing statistically diminishes with size.  Decisions decisions! 

[jerseygirl]

Hi Captoats,

My tumor also showed darkness in the center before both surgeries. The first time it was too large not to operate. The second time it was noticed by a radiosurgery specialist and not by any neurosurgeons I went to. I got excited when he mentioned it hoping that after 9 years of w&w my AN still does not require any intervention. Well, the answer was that ANs grow from the bottom or edges of the tumor, not its center. That means in time the center will darken further but the tumor will be larger and will have even more mass effect on the brain. That is why, if I went with radiation, it is important to kill the edges of a tumor so that thy don't grow.

This applies to ANs that grow. Some don't grow over time or grow in spurts. Darkness in the center of a tumor unfortunately does not in any way predict where you are going to be a year from now if you left this tumor alone. It is really up to you if you still want to w&w or do some kind of treatment. I think it is good to take Zyflamend even if it is not doing anything to your AN. It will minimize inflammation that the tumor is causing (and thus symptoms) and keep cranial nerves in top shape thus maximizing your chances of excellent outcome.

             Eve

[moe]

Hi  Captoats,
My MRI showed a "dark" spot  in the center of my AN, and one doctor thought it might be kind of dying in the middle.
But the surgery showed a vascular/bloody tumor instead. Not to say that you have a vascular tumor! They are not very common.
 Just maybe ask if they think this is necrosis or possibly vascular?
Do you have any brainstem involvement?
Good luck with your journey
Maureen

[captoats]

Hi Maureen and Jerseygirl,
Thanks for the input.  So far, my AN is just kissing the brainstem so that is a good question to ask the Dr. next week.  I haven't received the reading yet for this MRI with contrast so I'll see.  What is a vascular bloody tumor?  Is that something different from a AN or just a sub type?

[mk]

My AN also showed some small "blotches" that looked dark under contrast, pre-GK. After GK there was much more widespread darkening, with only the edges showing in white. So I would say that probably it is not atypical to show for ANs to show some inhomogeneity in contrast, even when not treated. If I remember well  it was mentioned on the forum once that if the imaging is done too quickly after the injection of the contrast agent, the contrast may not have the time to spread to the entire tumor. Darkening after radiation is quite noticeable, and widespread.

Marianna

[jerseygirl]

Hi captoats,

Most ANs are not vascular, that is, they don't have a lot of blood vessels in them. AN surgery is not considered very "bloody" by neurosurgeons. On the other hand, cancers are vascular and bloody. I was told that after GK cancers shrink significantly (or disappear) for this reason and ANs don't. Just for example, my AN was considered "medium vascularity".

        Eve

[moe]

 

 What is a vascular bloody tumor?  Is that something different from a AN

Sorry for the confusion. My AN was bloody, basically! Like Eve said, most AN's are not vascular, or bloody-(just another word for vascular). I was one of the unlucky ones. Like I said NOT common.
Will be interesting to see what your doctor thinks, and good thing it is just "kissing" the brain stem.
Maureen

[captoats]

Moe and Jersey,
Thanks for the input.  I am assuming vascular AN's are tougher to remove than the non vascular, am I correct?  I will definitely ask the question and go over the image slices with the surgeon and get his take on it.  In talking with some of the surgeons former patients, there was on guy that had a blood vessel feeding the AN that had to be cut before the AN could be removed.  Ended up as a 2 procedure removal! 

Yes so far, its just touching the brainstem with not much in the IAC. From what I have been told, that might give them a better chance of saving my hearing.  Got my fingers crossed!