Author Topic: an showing up on cat scan  (Read 4583 times)

cburley1

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an showing up on cat scan
« on: July 28, 2011, 06:40:20 am »
I had a cat scan in 2007 with & without contrast (plus 2 in 2004) that never showed a tumor... in 2010 it was already 1.6 cm. How did a slow growing tumor that I've been told that I've probably had anywhere from 8 to 16 years not show up till then....I don't know if it could have grown that fast....anyone have any answers or guesses...lol
1.6 cm into CPA  IAC an diagnosed in Nov, 2010..gamma knife in Feb 2011...facial nerve involved, only small section going into the brain stem shows on MRI, tumor either has it pushed aside or is wrapped around it, facial spasms & twitching, hearing loss, balance off, migraines....

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mattsmum

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Re: an showing up on cat scan
« Reply #1 on: July 28, 2011, 07:10:15 am »
hi there!
2 thoughts that popped into my head, without knowing all the details, are whether the right part of the brain was scanned in the past (was it specifically internal acoustic canals); and if it was - some acoustic neuromas do grow quicker than others, and the growth rate in any one tumour may vary over time.
someone has clearly used the 'average' growth rate widely quoted of 1-2mm/yr to extrapolate how long it MAY have been there - but that is only a rough guess at best; and may be completely wrong if your previous ct scans do genuinely exclude an acoustic in the past!
but these are clearly questions your doctors (who i hope will have all the details) need to at least try to answer for you. have you an appointment to see someone soon?
keep us posted,

vikki
LINAC radiosurgery july 2011 for 1.5cm tumour (uk)

cburley1

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Re: an showing up on cat scan
« Reply #2 on: July 28, 2011, 07:17:02 am »
Thank you Vikki...I had Gamma Knife and there is no necrosis of the tumor yet and my original neurologist (who always thought it needed to come out due to symptoms) is sending me to ear, nose & throat dr who specialises in surgery of this type of tumor...I go on Tues and I'm taking all my info to him...so I will ask.
1.6 cm into CPA  IAC an diagnosed in Nov, 2010..gamma knife in Feb 2011...facial nerve involved, only small section going into the brain stem shows on MRI, tumor either has it pushed aside or is wrapped around it, facial spasms & twitching, hearing loss, balance off, migraines....

.

mattsmum

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Re: an showing up on cat scan
« Reply #3 on: July 28, 2011, 07:20:43 am »
hope it goes well - and let us know,

vikki
LINAC radiosurgery july 2011 for 1.5cm tumour (uk)

Tumbleweed

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Re: an showing up on cat scan
« Reply #4 on: July 28, 2011, 12:05:30 pm »
I had a cat scan in 2007 with & without contrast (plus 2 in 2004) that never showed a tumor... in 2010 it was already 1.6 cm. How did a slow growing tumor that I've been told that I've probably had anywhere from 8 to 16 years not show up till then....

First of all, it is much easier for a radiologist to read an MRI than a CAT scan. CAT scans are better for planning radiation treatment but are not as easy for the eye to interpret as an MRI. So a smaller AN might have gone unnoticed by someone reading a CAT scan, whereas they may have noticed it more readily if they had been looking at an MRI.

Also, some people are more adept at reading images. Now that they know where the tumor is located, ask your doctor to take another look at the scans taken in 2007 and 2004 to see if they show the tumor and it was merely overlooked before. This is not merely an exercise in curiosity or a gauge of past (in-)competence. Only by looking at a series of scans over time can one gauge the AN's growth trajectory. Has it always been 1.6 cm, all the way back to 2004? Or has it undergone a huge growth spurt in the last few years? Knowing this could have an impact on how often followup scans should be taken or, if you haven't been treated yet, determining if treatment is urgently needed or a watch-and-wait approach is still tenable.

Finally, the quality of past images may have had an impact on the tumor's late discovery. Scanning technology continues to improve. And some facilities offer better (the "latest and greatest") imaging machines than others.

To wit, I have a small hypoglossal tumor (located at the base of the brain) that went unnoticed for at least a couple years. Initial MRI scans revealed the tumor's presence, but radiologists didn't notice it, in part, because the image was fuzzy. A couple years later, I went to Stanford for treatment for my AN. A CT scan was taken to plan my treatment. Once again, the hypoglossal tumor was not noticed, because it was so small and because a CT scan is, once again, hard for the eye to interpret. Five months after receiving CK, I had my first followup MRI series taken at Stanford. (My previous MRIs were all taken at a different facility, not Stanford's.) A radiologist at Stanford noticed my hypoglossal tumor while looking at my first MRI series taken at Stanford. This prompted my Stanford doctors to look at my past MRIs that had been taken elsewhere. I also took a look at all my MRIs. The earliest MRIs show the hypoglossal tumor, but it is a fuzzy image. The one taken at Stanford show a much sharper and clearly defined image of the tumor.

Equipment, a trained eye and the type of scan used -- they all contribute to whether a tumor is noticed early on or not.

Best wishes,
TW
L. AN 18x12x9 mm @ diagnosis, 11/07
21x13x11 mm @ CK treatment 7/11/08 (Drs. Chang & Gibbs, Stanford)
21x15x13 mm in 12/08 (5 months post-CK), widespread necrosis, swelling
12x9x6 mm, Nov. 2017; shrank ~78% since treatment!
W&W on stable 6mm hypoglossal tumor found 12/08

mk

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Re: an showing up on cat scan
« Reply #5 on: July 28, 2011, 06:19:52 pm »
Thank you Vikki...I had Gamma Knife and there is no necrosis of the tumor yet and my original neurologist (who always thought it needed to come out due to symptoms) is sending me to ear, nose & throat dr who specialises in surgery of this type of tumor...I go on Tues and I'm taking all my info to him...so I will ask.

This just caught my eye. What do you mean by "there is no necrosis of the tumor?" Is it still growing? Necrosis usually means the darkening at the centre that may or may not show up in an MRI with contrast, but absence of this darkening doesn't necessarily mean that the GK has failed. (and vice versa, as mine did show necrosis but continued to grow).
If I understand well, you had treatment in 2010 - Usually radiation oncologists wait at least 2-3 years before declaring that radiosurgery has failed. Tumor swelling is not uncommon this early after treatment. Make sure to ask exactly why they think that the treatment has failed, and don't let them rush you into anything.

Marianna
GK on April 23rd 2008 for 2.9 cm AN at Toronto Western Hospital. Subsequent MRIs showed darkening initially, then growth. Retrosigmoid surgery on April 26th, 2011 with Drs. Akagami and Westerberg at Vancouver General Hospital. Graduallly lost hearing after GK and now SSD but no other issues.

PaulW

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Re: an showing up on cat scan
« Reply #6 on: July 28, 2011, 08:39:32 pm »
Thank you Vikki...I had Gamma Knife and there is no necrosis of the tumor yet and my original neurologist (who always thought it needed to come out due to symptoms) is sending me to ear, nose & throat dr who specialises in surgery of this type of tumor...I go on Tues and I'm taking all my info to him...so I will ask.

Wow.. Definitely get a second opinion.
Tumours swell after radiation, sometimes a lot, like 100%
Just because the MRI does not show necrosis doesn't mean it is not dead or dying.
I believe around 20% of tumours show no enhancement changes on the MRI and do stop growing.
Success Rates are 98% at 2 years dropping to around 96% after 5 years.
It normally takes 2 years at least before radio is called a failure.
The ones that fail before 2 years are normally large. Often failure is caused by the tumour swelling to the point where it becomes dangerous. the treatment still could have been successful, but it becomes to dangerous to find out.

Another opinion is definitely warranted, preferably someone that specialises in Gammaknife or radiation treatments 


 
10x5x5mm AN
Sudden Partial hearing loss 5/28/10
Diagnosed 7/4/10
CK 7/27/10
2/21/11 Swelling 13x6x7mm
10/16/11 Hearing returned, balance improved. Feel totally back to normal most days
3/1/12 Sudden Hearing loss, steroids, hearing back.
9/16/13 Life is just like before my AN. ALL Good!

leapyrtwins

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Re: an showing up on cat scan
« Reply #7 on: July 29, 2011, 05:59:09 am »
Personally, I don't think CAT scans are the most reliable vehicle out there.

I'd get an MRI w/contrast; much sharper images.

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

cburley1

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Re: an showing up on cat scan
« Reply #8 on: August 03, 2011, 07:41:46 pm »
WELL....GOOD NEWS FOR A CHANGE...WENT TO THE SPECIALIST IN PITTSBURGH...(WHO I ABSOLUTELY LOVE)....MY TUMOR IS SHOWING NECROSIS....AND HAS NOW SHRUNK ABOUT 2 MM...IT IS PUSHING ON MY BRAIN & BRAIN STEM, ALSO IT IS EITHER INVADED OR PUSHING ASIDE MY FACIAL NERVE, BUT HE DOESN'T WANT TO OPERATE RIGHT NOW, THE SCARRING FROM GK MAKES IT HARDER AND AS LONG AS IT IS DYING I WILL BE OKAY, HE WANTS AND MRI IN FEB, IF IT HAS GROWN ANY AT ALL THEN IT DEFINATELY WILL HAVE TO BE REMOVED, BUT HE IS REASONABLY CONFIDENT THAT IT WON'T GROW, THAT BEING SAID...HE SAID HE UNDERSTANDS WHY THE OTHER DOCTORS RECOMMENED GK, BUT IF HE HAD BEEN MY DOCTOR IT WOULD HAVE CAME OUT A YEAR AGO, AT THIS POINT MY BALANCE ON RIGHT SIDE IS SHOT, BUT HE SAID I HAVE COMPENSATED WELL WITH LEFT SIDE, AND I ACTUALLY NEED HEARING AIDS IN BOTH EARS AS I'VE LOST MORE HEARING SINCE GK, GIVEN THE LOCATION OF MY TUMOR AND THE SPEED THAT IT HAS GROWN (HE LOOKED AT CAT SCAN FROM 2007) ABSOLUTELY NO TUMOR AT THAT TIME...HE REALLY THINKS IT SHOULD HAVE COME OUT THEN...BUT RIGHT NOW THE GK TREATMENT SEEMS TO BE KILLING THE TUMOR SO THAT IS VERY GOOD NEWS, WE REALLY THOUGHT WE WOULD BE SCHEDULING SURGERY....YEAH......THANKS FOR THE PRAYERS, SUPPORT & ENCOURAGEMENT...I HOPE THIS MAKES SENSE...LOL
1.6 cm into CPA  IAC an diagnosed in Nov, 2010..gamma knife in Feb 2011...facial nerve involved, only small section going into the brain stem shows on MRI, tumor either has it pushed aside or is wrapped around it, facial spasms & twitching, hearing loss, balance off, migraines....

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