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Suggest Treatment For Recurrent Meningioma

Posted on Mon, 29 Dec 2014

Question: Hi Drs.

can anyone describe what exactly this MRI brain with contrast scan says, its post radio therapy of a recurrent meningioma.

Thanks,
XXXX

Answered by Dr. Sudhir Kumar (9 hours later)

Brief Answer:
Meningioma has recurred as per the MRI report.

Detailed Answer:
Hi,

Thank you for posting your query.

I have noted the findings of the MRI report.

As per the report, there is a meningioma in left side of brain, which is suggestive of a recurrent tumor. This means that the tumor has grown again in the same place.

I hope my reply has helped you.

I would be pleased to answer, if you have any follow up queries or if you require any further information.

Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Sudhir Kumar (4 hours later)

Thanks for your prompt response Dr.

I would like to give you an patient's meningioma history.

My mom aged 46 years has undergone Craniotomy surgery twice within 18 months duration. First one on Aug'12 and the second one on May'14.

In the first Biopsy, tumor is recognised as WHO Grade-I Meningioma.

In Second Biopsy, tumor is recognised as WHO Grade-II Atypical Meningioma.

On observing the upgrading(from Grade-I to Grade-II) tumor within short span, Doctor suggested to go for Radiotherapy. So one of the Radiation Oncologist prescribed us to go for RapidArc Radiotherapy. Mom has underwent all the 30 doses of the RT session(June'14).

1. your prediction about tumor is correct. Even after 2nd surgery, Surgeon didn't remove the tumor to the fullest. Its only 4 months since RT, Just want to know whether RT helped out or not.
2. If its a recurrent tumor, what are the steps to be followed as a precautionary measures.

Can you please suggest any alternative to get rid of this disease, as the patient has undergone 2 major surgeries and a RT already.

Please find the attachements for more clarification about this case.

Thanks,
XXXX

Answered by Dr. Sudhir Kumar (51 minutes later)

Brief Answer:
RT has not fully helped.

Detailed Answer:
Thank you for getting back.

1. Looking at the size of recurrent meningioma tumor, it seems that RT has not helped. This can happen in some meningioma, which are classified as radiation refractory meningiomas.

2. The treatment options at this stage could be another operation to remove the tumor, as it is present in a location, where surgery can be done without any significant risk.

RT can be given again, if there was initial response. However, in this case, repeat RT may not help.

Medical treatment options are available, which include hydroxyurea, IFN-α and Sandostatin LAR, a somatostatin analogue.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (10 hours later)

that was a good information Dr.

can you please brief into what these Medical treatments hydroxyurea, IFN-α and Sandostatin LAR, a somatostatin analogue does.

Thanks,
XXXX

Answered by Dr. Sudhir Kumar (5 hours later)

Brief Answer:
These medications reduce the growth of tumor.

Detailed Answer:
Thank you for getting back.

These medications reduce the growth of tumor, as in recurrent meningioma.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar