Initial measurement, then shrinks, then grows What's up with this?

[Nancy Drew]

I was diagnosed with AN 4mm x 5mm left ear Dec. 2005.  The six month MRI said it was 4mm x 2mm.  Got the results of yearly MRI a couple of days ago, and it read 4.5mm x 4.5mm.  The doctor wasn't aware that the AN had jumped from 2mm to 4.5mm until I reminded him to read last years report.  He said he couldn't understand why the doctor read it that way last year, and then said he would check on it.  In the meantime he said to look out for any worsening hearing loss, balance issues and ringing in the ear.  Otherwise just get the repeat MRI next year.  I don't have any major symptoms right now.  Just have slight hearing loss from time to time and some balance issues, but that could be due to a knee injury this past year.  Since my AN is so small, does it matter that these numbers are not exact one way or the other?  I've been told that MRIs are often not taken or read the same way and could account for variations in the numbers.  Still, increasing from 2mm to 4.5 mm makes me wonder what is going on.  I think I'm ok, but I just wanted to hear what any of you have to say.  I really doubt the doctor will get back to me since I don't think he will check on the measurements.  He seems to have a lot of patients.  I'll call in a couple of weeks though just because I think he needs to do his job and check.  Thanks for listening.  Nancy   

[Yvette]

I sure have trouble understanding the watch and wait thing. As soon as I knew I had a tumor I wanted it OUT OUT OUT. I would think of nothing else if I was watching and waiting. Do call that doctor back! Birddog him honey-if he won't put your care first, you've got to. I wish you the best, Yvette

[Battyp]

I'm curious...is your mri from the same place and read by the same doc?

[Jim Scott]

Nancy Drew:

As Bruce mentioned, MRI scans have a margin of error regarding exact measurement. 

My last MRI (April 30th - almost 11 months post-op and 4 months following my last MRI) showed definite tumor necrosis.  I did better than ever on my neurological tests.  However, the MRI scan indicated that the tumor had increased in size a bit, which concerned my neurosurgeon but didn't make sense considering the obvious necrosis and my improved neurological responses.  He ordered another MRI to be taken later this month.  Same hospital and MRI unit, just to be accurate.  I now think it was simply a measurement error, but we'll see what happens when I have the next MRI scan (June 20th). 

In your case, if you have few symptoms, you are probably O.K. to 'watch-and-wait', as we call it, even with the jump in the AN numbers, which are a legitimate reason for concern and need to be checked out.  Your doctor's casual attitude about this - considering the consequences of ignoring a growth spurt in your tumor - is not reassuring.  You may want to consider a second opinion.  Meanwhile, do not become alarmed as the tumor is fairly small and, if it starts to grow, can probably be radiated.

Jim

[Nancy Drew]

Thanks everyone for posting.  I called the doctor's office and requested a written copy of my MRI results.  All MRIs have been done at the same facility, but the first two were read by different doctors.  I am waiting to see if the third one was read by one of these doctors.  Knowing this fact should answer some of my questions about growth.  But, I do feel confident that I will be able to watch and wait for now due to no major symptoms.  I should have been more on my game when I went to see the doctor a couple of weeks ago.  I totally did not think to ask about who read the MRIs.  I have found some names of more doctors here in Denver to go see so I might go for that second opinion.  Wouldn't hurt.  Hope my PCP will give me the referral.  Nancy