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June 10, 2013
Mar 20 Email: Tumor Diagnosis
I had a clinical visit with my expert spinal neurosurgeon to review my second cervical spine MRI (with tractography) on March 20, 2013. Later that day, I put this email together.
Date: Wed, 20 Mar 2013 22:37:12 -0400
From: Jon Nathan
Subject: Re: Neurological issues
Thanks again everyone for your concern and support. This afternoon
I met with my Neurological Surgery specialist. We reviewed the
images and report of my MRI with Tractography from March 1st. He
thinks that they indicate a tumor. The mass is diffuse, but the
details of the enhancement itself, the surrounding edema, and rate
of progression are consistent with a tumor.
In radiology terms, the word enhancement means an abnormally bright
area in the image. The enhancement is larger than my first MRI in
early January, and the swelling around it is greater too. It's
still relatively small, about 3mm, but it's in the spinal cord and
intertwined with some nerve tracts. This is not the best news,
especially since he originally thought it was not a tumor. But the
differences between my original and recent MRIs lead him to this
diagnosis now.
I'm going to get a 4th opinion from an expert neurologist. He will
try to determine if it could be any process (inflammation, sarcoidosis,
demyelinating lesion) besides a tumor. I hope to have this in the
next week or so.
Assuming the consensus is that it is a tumor, I'll likely undergo
surgery in a few weeks. The surgical procedure is tricky because
it's a small mass in a delicate space. The neurosurgeon would
perform a laminectomy of my C4-C6 vertebrae and locate and remove
the abnormal cells. Then a neuropathologist on site would examine
the cells under a microscope to try to identify them. Likely the
initial results will be inconclusive, and samples will be sent to
a lab for further tests. The mass itself could be one of many
things, and is likely benign. This identification will determine
future treatment (radiation, chemotherapy, steroids, etc).
My symptoms are still roughly the same, and they still fluctuate a
bit. Whatever this turns out to be, I think I'll be fine in the
long run. Prognosis for this procedure on someone of my age and
health is generally pretty good.
I'd like to continue to keep this information private until I get
a more definitive diagnosis. By that, I mean don't post it to
Facebook :)
Thanks again, and I will keep you posted.
-Jon
Posted by jon at June 10, 2013 12:27 AM