Kippy,
I'll throw in my 2 cents for what's it worth although I would certainly echo most of the comments made by Joef, Tony and Battyprincess. At just under 3 cm you are certainly within the range where radiosurgery is an option worth exploring with someone who is well trained in that discipline as opposed to someone who primarily does surgery. It is correct to say that 3 cm has been the conventional upper limit standard based on the GK studies. I believe CK has been able to expand that range safely based on it's greater level of accuracy but there are many other factors to consider as others have noted in making the best treatment decision for you.
I have no idea what an "arachnoid" cyst is but below is a response from one of the docs over on the CK message board addressing cystic AN's which may be of some help:
"Cystic" merely describes the presence of a significant fluid collection (or cyst) within the tumor. While very descriptive radiologically, we don't really use this to determine much. In fact, I just saw a 96 month follow-up from Gamma Knife of a large cystic AN that has shrunk to almost nothing and continues to shrink with each follow-up study. I would not say that being cystic, in and of itself, precludes CK or radiosurgery in general.
William S. Rosenberg, MD
Medical Director, Menorah Medical Center CyberKnife
Midwest Neurosurgery Associates
6420 Prospect Street, Suite T411
Kansas City, MO 64132
(816) 363-2500
wsr@post.harvard.eduIt might be helpful for you to post your question on this issue to one of the docs there at
www.cyberknifesupport.org and see if "arachnoid" changes anything. They also might be able to address some of the treatment size questions.
Also, HEI is not the only place that will review MRI's for free. Dr. Chang at Stanford does it as does Dr. Medberry in Oklahoma city and I'm sure a host of others
do as well. From my perspective, the larger size of your AN does not not preclude either treatment option, but it does require going to very experienced docs in both areas to get a fair appraisal. HEI is a great place for a surgical consult but based on the dozens of people I talked to who have gone there to explore treatment options I've yet to hear that they've ever recommended radiosurgery to anyone, regardless of size. While someone on this board has stated in the past that they actually have a GK available, a quick read of the misinformation on radiosurgery on their web site reveals their bias. If you decide on surgery as the best choice for you, I would certainly concur with many other folks on this board who have had surgery there that they are the premier place to go. Experience counts for a lot with AN's and the docs there definitiely have a lot. My only point is that I would personally not trust their knowledge or opinion of radiosurgery in making my final decision.
Best of luck to you
Mark
