3 years follow-up after Retro-sigmoid craniotomy, again decrease in residual...

[rm516]

Had 3 yrs follow-up MRI with and without contrast just 2 days ago and was happily informed today by  MRI report that "In comparison to prior examination is unchanged as the comparative measurement is not possible given differences in slice position and angulation. Current tumor measures 1.1 x 1.5 x 0.8 cm in greatest dimension previous tumor measured in similar location 1.3 x 1.5 x 0.9 cm."

I will take it, as the size of the remaining tumor has again decreased or remained unchanged from 3.5 cm original to 1.9 cm size post-operatively. Grateful to Dr. Michael Sisti of Columbia presbyterian, NY for the surgery with minimum deficits. Seeing him on 2/9 for the annual visit.Details later..

[ANSydney]

It looks like partial tumor removal may have been the key.

[JLR]

That's great!!  I had my 3 month MRI post op today. It appears the 5% that was left wrapped around the facial nerve has begun to grow. Will probably need radiation. Who has had a re growth?  Will the radiation affect the facial nerves. I still have a bit of facial paralysis although it's getting better.  Many thanks. Joan

[rm516]

Met Dr. Sisti today for the yearly follow-up. He said everything looks stable and I may not need any prophylactic treatment (GK) and might have been already cured!!He went on length to tell me that he made a V-shaped groove during surgery, in the tumor (it went over my head for those technicalities  )and now my brain is slowing coming back to the original state (compensating) and that's why my hearing seems to be getting better (as I told him that I can hear much better from the tumor side right ear). All's fine but still asked me to see him after a year. Dr. Sisti again inquired about my family's well-being and talked about his children too. Really makes you feel very comfortable with these pleasantries. (called me still very young  )

[ANSydney]

It would be good if Dr Sisti's method was presented for the benefit of all.

[JLR]

My debulking the AN measurements directly after surgery 3x12x7 mm left on facial nerve. 3 months later recent follow up MRI measures 6x11x7mm. It grew 3mm. Seeing radiologist tomorrow as they want to zap before it gets bigger. Of course I will get 2nd opinion but is 3 mm a lot? Would appreciate some feedback. Many thanks Joan

[ANSydney]

Given that there is a 2mm measurement error, 3 mm isn't much. You could argue that it shrunk 1 mm in its longest dimension. If it was me, I would wait for two more MRIs and see what the growth pattern is. I would also look at the  MRIs myself.

[JLR]

Thanks very much. The surgeons assistant said it has grown substantially but after reading your reply it isn't a very big re growth. Again thanks. I'll keep posted after I see radiologist tomorrow. Joan

[alabamajane]

Joan,
I know you will be glad to speak to the radiologist tomorrow,, I'm sure by now you know what you want to ask about,, I would also get another opinion if you feel the need. Doctors know more than most of us here.

With yours being wrapped around the facial nerve, it seems growth will not be the only determining factor in further treatment,,, it isn't like the first surgery when you did not know what nerves were being impacted. Now that the residual tumor is on the facial nerve, you know it  is what will eventually be impacted,, I, personally would not want to wait for it to further compresss that nerve before doing treatment if it is recommended by several doctors,,

Let us know what the radiologist says,,,

[ANSydney]

Joan, alabamajane is right. We can offer unqualified opinion, however this is no substitute for expert professional advice. Get a wide variety of expert advice and make an informed decision. You can't get to many professional viewpoints.

[ANSydney]

Joan, forgot to mention that it's important to get the same place to do the MRI and same radiologist to do the measurement. There is variability between measurements with the same radiologist - there's even more between radiologists. (I got my MRI on disk and double checked the measurements and took a good look at the beast that dwells within.)

[JLR]

Yes very true. Will have MRI in 3 months. Radiologist wasn't convinced there was a growth as the residual tumor as well as myself is still recovering. Right after surgery the MRI could not be measured because of it post op position. The 3 month visit will be very telling. I'm much relieved. Thank you all for your great knowledge and kindness. Of course I'm still dealing with my eye. But no pain, no aversion to light or wind so it's improving.  Joan

[ANSydney]

Great to hear Joan. Good luck with the 3 month MRI. (My first followup MRI is in a week. Then I'll know it's natural course.)

[JLR]

Hopefully the MRI is uneventful keep us posted. Many thanks.