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What Does This MRI Report Indicate?
Question: Hello, my uncle had been suffering from back pain, leg pain and gluteal pain since last 2 months. Approx 7-8 kg weight loss.
MRI spine was done and reports suggest possibility of ependymoma (Reports attached). He has been advised tumor excision by neurosurgeon.
He is known case of thalassemia minor, DM and a known smoker.
On pre-surgical fitness evaluations, high blood sugar was reported along with Kohl's lesion in right upper lung on X ray. Hence, he underwent CT thorax ( Reports attached). MT test report awaited. ESR is 56. Except weight loss he doesn't show any other symptoms of TB. ....attached file contains all the reports
Now, CT guided biopsy is suggested. So I have few queries-
1 . How long spine surgery can be differed?
2. What should be priority?? TB or ependymoma??
3. Is CT guided biopsy must prior to surgery or it can be done post spine surgery??
4. Prognosis
MRI spine was done and reports suggest possibility of ependymoma (Reports attached). He has been advised tumor excision by neurosurgeon.
He is known case of thalassemia minor, DM and a known smoker.
On pre-surgical fitness evaluations, high blood sugar was reported along with Kohl's lesion in right upper lung on X ray. Hence, he underwent CT thorax ( Reports attached). MT test report awaited. ESR is 56. Except weight loss he doesn't show any other symptoms of TB. ....attached file contains all the reports
Now, CT guided biopsy is suggested. So I have few queries-
1 . How long spine surgery can be differed?
2. What should be priority?? TB or ependymoma??
3. Is CT guided biopsy must prior to surgery or it can be done post spine surgery??
4. Prognosis
Brief Answer:
CT guided biopsy should be done prior to spine surgery.
Detailed Answer:
Thank you for posting your query.
I am Dr Sudhir Kumar, Neurologist, and I would try my best to help you.
I have noted the new reports of your uncle. I would answer your queries, however, the order of questions may be changed.
It is important to know whether the lung lesion is TB or not (prior to spine surgery). Hence, CT guided biopsy of the lung lesion should be done first. It is minor out-patient procedure, and the reports are usually ready in 5-7 days.
Once the biopsy report of lung lesion is ready, he can be started on anti-TB medications if the biopsy report confirms TB.
After this, the spine surgery can be done. All this should not take more than 10-14 days. So, the spine surgery can be deferred for this period (about two weeks).
TB has an excellent prognosis, if treated on time and with appropriate medications, for full duration.
Ependymoma prognosis would depend on the grade of tumor (which will be known after the surgery and biopsy report). Generally, it has a good prognosis.
I have noted your clinical details. Based on this
I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.
Wishing you good health,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in
CT guided biopsy should be done prior to spine surgery.
Detailed Answer:
Thank you for posting your query.
I am Dr Sudhir Kumar, Neurologist, and I would try my best to help you.
I have noted the new reports of your uncle. I would answer your queries, however, the order of questions may be changed.
It is important to know whether the lung lesion is TB or not (prior to spine surgery). Hence, CT guided biopsy of the lung lesion should be done first. It is minor out-patient procedure, and the reports are usually ready in 5-7 days.
Once the biopsy report of lung lesion is ready, he can be started on anti-TB medications if the biopsy report confirms TB.
After this, the spine surgery can be done. All this should not take more than 10-14 days. So, the spine surgery can be deferred for this period (about two weeks).
TB has an excellent prognosis, if treated on time and with appropriate medications, for full duration.
Ependymoma prognosis would depend on the grade of tumor (which will be known after the surgery and biopsy report). Generally, it has a good prognosis.
I have noted your clinical details. Based on this
I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.
Wishing you good health,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in
Above answer was peer-reviewed by :
Dr. Yogesh D
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