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DEAR DR. ROACH: In January 2014, I was diagnosed with a benign neoplasm of my cerebral meninges (meningioma). I am a healthy 64-year-old Caucasian woman. I do not take any medications. The finding was incidental. I have no symptoms from the meningioma. I sometimes feel as if my mental capacity has declined somewhat (such as memory), but I attribute this to the normal aging process. I have been getting an MRI every year since the diagnosis.
The last test showed that the tumor was 2.9 cm by 1.6 cm by 2.7 cm. The mass measured 2.3 cm by 1.3 cm by 2.1 cm when I had the first MRI in 2014. It seems to be slowly growing. What are your thoughts on this? Do you advise surgery at this time? – C.C.
ANSWER: A meningioma is a type of brain tumor that arises from the meninges, the lining of the brain. Most of these are benign, although they do range from benign to cancerous. Even the cancerous tumors very rarely spread.
The main problem with this type of tumor is that they grow, and there is not a lot of room inside the skull to spare. An enlarging tumor can compress the brain, and that can lead to symptoms. Depending on the exact location of the tumor, it can cause weakness, loss of vision or loss of hearing or smell. Another common symptom is a seizure. Changes in mental function are less common, but I am very cautious about ascribing symptoms to aging.
Although the change in size seems small, the tumor has approximately doubled in size since 2014. That is a clear indication for treatment. It will likely keep growing and cause symptoms. Surgery is a treatment option, as is radiation, but only an expert can make the assessment of what is best in your situation. If the tumor is in a favorable location, most authorities would recommend surgical removal of the tumor.
DEAR DR. ROACH: My 59-year-old son has cirrhosis, probably from a blood transfusion he had as a teenager. His gastroenterologist tells him he is two years away from going on the transplant list for a new liver. Do you know if someone with compatible blood could donate a piece of his or her liver? Would that provide him with enough healthy liver? Also, he heard that you live only about five years with a new liver. Is that true? – B.M.
ANSWER: Cirrhosis after a blood transfusion makes me suspect that your son’s liver disease is due to hepatitis C. If that’s the case, his gastroenterologist has had or will have a discussion with him about new treatments for hepatitis C that will hopefully keep him from needing a transplant.
However, if he does need a transplant, it can be done from a family member or even from a nonrelated person. There are risks to the donor, but major complications happen in only 1 to 3 percent of cases. The transplanted lobe of the liver does rapidly regenerate. The results for the recipient are comparable to that of deceased organ donors. Only the transplant surgeons can recommend whether a living donor is possible.
For adults in your son’s age group, the likelihood of surviving five years after liver transplantation is about 70 percent.
Dr. Roach regrets he is unable to answer individual letters, but he will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.
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