Talk to Neuro Physician on Diagnosis Dilemma Without Biopsy. Brain Mets/cavernoma/primary Tumour
Asking for Brother, Male, 17 years old, Islamabad
Aoa. I seek advise from all respectable oncologists of Pakistan. My brother aged 17 developed neck stiffness on 1st april 2023 (1 month ago), next day he was feeling extremely down and nauseous. On 3rd april he was brought to ER because he was persistently vomiting ,had complains of vertigo, numbness on left side of body. On 10th april 2023 , his MRI brain showed cervicomedullary lesions. On doctor recommendation he was admitted in PIMS. There doctors have told us to take my brother to lahore karachi for gamma knife or cyber knife as this lesion is inoperable + biopsy from it is also impossible according to all neurosurgeons of Islamabad. Without diagnosis, treatment is not possible. He has 3 differentials on MRI report. It is important that I mention that he had cancer diagnosis of embryonal rhabdomyosarcoma (nasopharyngeal) at 7 years of age in 2013 which was followed by resection through surgery, chemotherapy, radio therapy then again chemo therapy till 2015. Pet scan 2017 showed n
Dr. Rai Muhammad Fazal Ur Rehman Khan - Cancer Specialist / Oncologist
MBBS, FCPS (Radiation Oncology) | Faisalabad
30 Positive Reviews
you Have consulted Dr Muhammad Furrukh (SiH) and Dr Qasim Buttar (PIMS).both are very competent oncologists.
as far as second opinion regarding biopsy is concerned you can consult Dr athar inam at AKUH , being a neurosurgeon he can tell you regarding pros and cons of biopsy at this site.
kindly take your previous radiation record with you while consultation regarding stereotactic radiation .
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Patient
Post Owner
My brother had radiation from allied hospital faislabad in 2014 under Prof Dr ijaz Shah hussain. As it has been almost 10 years hospital has discarded the data and dr ijaz shah hussain retired in 2015. All allied hospital provided us was file number for data access which is of no use now. Please guide me how can I now have access to previous radiation record of my brother
3 years ago
MBBS, FCPS (Radiation Oncology) | Faisalabad | Book Appointment
allied hospital had and still has Cobalt technology. and technique must be 2D at that time. by viewing old imagimg films reports for disease site , Old Radiation Record for dose given and number of fields , one can have some idea how much dose can be given by minimizing radiation toxicity. I'm not a neurosurgeon but site of current disease looks very high risk for Biopsy. so in my opinion kindly pursue with plan given by your primary oncologist.
3 years ago
Patient
Post Owner
Plan of primary oncologist (dr zeba aziz)? Please sir help me understand that. Do you think without biopsy after radiotherapy ,we should assume it is metastasis and repeat the chemotherapy of Embryonal Rhabdomyosarcoma? Is it possible?
3 years ago
MBBS, FCPS (Radiation Oncology) | Faisalabad | Book Appointment
Dr zeba Aziz is professor of oncology and of the best oncologist in Pakistan . the reports shows lesion in brain stem and near origin of spine. the biopsy of this area is quite high risk. this can lead to various complication even to death. thats why neurosurgeons in rwp/isb have refused biopsy. if radiologist Dr Bilqees yawar has raised the suspicion of mets then there is high probability of mets and I'll honor her opinion . for 100% diagnosis can only be granted by biopsy which is not possible in this case . so oncologist will proceed with radiotherapy ( depending upon previous Radiation plans and assessment by radiation oncologist).and chemo . u should ask same question with your primary oncologist. baqi Allah karam karay.
3 years ago