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What Does My CT Scan Report Indicate?

Posted on Tue, 27 Jan 2015

Question: Some medical history: I am a 23 year-old male in great health. I was born premature. As an infant, I underwent surgery for the correction of craniosynostosis. About a month ago, I had a CT scan done of the head. It was for a simple headache, but I have been having severe health related anxiety as of late for some reason, so even though my clinical exam was fine, I requested a CT scan against the advise of my doctor. (I think my stress and anxiety have come about as a result of planning a wedding and renovating our home.) On the CT scan, There was an incidental finding, which the radiologist called a "6mm, partially calcified possible meningioma of the right frontal lobe.. Dural-based near the vertex." The doctor who went over the results said this was nothing to worry about, but she sent that to my PCP. My PCP said also not to worry, but sent me to a neurologist. The neurologist's exact words were, from reading the radiologist's report, "forget you have it. It's probably insignificant, if it is a meningioma at all." Being anxious as I am though, I have been searching google for meningiomas and my anxiety has just gone through the roof because no one has given me a 100% answer and I worry a lot.. My question is, is this something I should worry about? I have read that because I am young that surgery is recommended, but that goes against what the neurologist and examining physician told me. What are the odds this is a meningioma? Is dural-based scar tissue (inside the skull?) a common occurrence after a procedure like correction for craniosynostosis, and could I be worrying over something I've had my entire life? Is there any way to tell what it is for sure?

Answered by Dr. Geldon Fejzo (45 minutes later)

Brief Answer:
consider it an incidental finding.

Detailed Answer:
Hello. I have been through your detailed question and understand your concern.

Basically you had a CT scan without any clinical indication, so any finding in the ct would have been considered an incidental finding.

The finding in the CT which is a lesion attached to the dura and calcified has all the features of a meningioma. The natural history of this lesion is benign, especially since it is calcified.

As all my previous collegues I would do nothing about it, but have a second CT scan in a year time and see its dimmensions trend. Meaning if it is growing, shrinking or staying stable which is the most probable option.

So, you have no serious problem to worry about. Just have a CT scan after one year.

Hope this helps. Please feel free for further questions.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Geldon Fejzo (1 hour later)

Thank you very much Dr. You say the natural history of the lesion is benign, especially since it's calcified and will probably not grow. Does that apply even though it's partially calcified and not completely calcified? Also, what are the odds that this is scar tissue from my previous surgery for craniosynostosis? I was told by my neurologist that with my surgical history there is the possibility that this could be scar tissue and not a meningioma at all. Is that a common finding with a previous skull surgery?

Answered by Dr. Geldon Fejzo (23 hours later)

Brief Answer:
It is not a scar tissue

Detailed Answer:
Hello. I would exclude that being a scar tissue. It is uncommon a bone tissue proliferation as a scar, plus it is reported to be dural based, which means it does originate from the dura which is a layer inside the bone.

It is not important if it is calcified completely or not, it is important that it has calcium which is a sign of benign nature.

Still, only histology can define for sure its nature, and to obtain the specimen you should have surgery, which is unnecessary for the moment, because surgery risk are greater than its natural history.

Hope this helps. Wish you the best health.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Geldon Fejzo (34 minutes later)

If I repeat the exam in one year, and there is no growth reported, how do you suggest I proceed? I would rather not spend the rest of my life scanning this if it is unnecessary, as I already suffer from anxiety issues and I feel these situations just make it worse. My initial neurologist told me that this growth would be best forgotten. Is that your opinion as well?

Answered by Dr. Geldon Fejzo (12 hours later)

Brief Answer:
It is very probable it won’t grow

Detailed Answer:
Hello. According to the radiologic features, it is very probable it will not grow. But you need some evidence to support this eventuality, which is a ct scan in a year period. Till then there is nothing to worry about.

Happy New Year

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju