Friday, February 13, 2009

If it sounds scary, it probably is.

No, we're not talking about Friday 13.

So after much hesitation, I've finally got my latest MRI scan done in Hospital UKM. By looking at this report, it looks like I've got a hill to climb. I still want to get my PT (proton therapy) done in Boston so I'll climb that hill if that's what it takes for me to get a better chance at eliminating this cancer.
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MRN: N211322
MRI Brain 12 Feb 2009

Clinical data:
30 y.o male, k/c aggressive recurrent mesenchymal chondrosarcoma. Multiple debulking done 2006-2008. Rt enulcleation done Sept 2008. MR to reassess tumor. KIV debulking.

Sequence:
Arial: T1WI, T1W1, FLASD2D
Coronal: FLAIR
Sagital: T1W1

Comparison made with previous MR dated 23 09 2008.

Findings:
The previously seen heterogeneously enhancing mass in the right middle and anterior cranial fossa is currently larger, measuring 8.7 (w) x 6.4 (ap) and 9 am (cc). It is relatively hypo to isointense to grey matter on T1W and slightly hyperintense in T2WI & FLAIR.
Medially the mass crosses the midline and obliterates the entire post-nasal space. The mass also involves both cavernous sinuses, however both ICA are patent.
Superiorly the mass extends into the extradural component of the right anterior and middle cranial fossae. There is also extension into the right frontal sinus causing fluid retention.
Posteriorly there is involvement of the right temporal lobe and the clivus with surrounding edema.
Anteriorly there is evidence of right orbital enulcleation and the orbital space is replaced by the mass. No clear demarcation between the mass and the posterior wall of the right maxillary sinus. Presence of fluid retention within the right maxillary sinus.
Inferiorly the mass extends to the right pterygoid fossa region, with involvement of the medial and lateral pterygoid plates and muscles. The right parapharyngeal space is obliterated. The normal configuration of the right parotid gland is not appreciated, which is suggestive of infiltration into this gland. No prevertebral extension as the mass is limited posteriorly by the prevertebral fascia.
Laterally the right infratemporal space and right masseter muscle are involved.

The previously seen enhancing mass in the right parietal scalp (tumor deposit) is no longer present.

No other focal lesion within the brain parenchyma.
No midline shift.
No hydrocephalus.

Impression:
Known case of mesenchymal chondrosarcoma which shows worsening of the local extension compared to previous MRI.

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I'll see if I can get some MRI images up here in the next few days. No promises because I'm doing quick posts from the hospital and I don't think it's even allowed but they were nice enough to oblige.

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