HoleinBoneParticipantMarch 13, 2020 at 1:04 amPost count: 3
Dear Dr Corenman,
I wonder if this tumor on my L-4 is a Hemangionoma.
I do not know how to attach a picture.
However, I believe it is growing and taking more bone on my L-4 vertebra near the facet.
It seems like if it keeps growing it would be good to have treated, only the doctors I have spoken to are vague in their response. The cyst/tumor has carved a window through the bone. I had both a CT scan in 2018 and in 2019, along with an MRI in 2019 so it appears to me to be more distinct with clear edges in 2019 vs 2018.
I wonder if you could give a more definitive answer as to it’s treatability. Would you treat it? Is it something of concern?
JoyDonald Corenman, MD, DCModeratorMarch 13, 2020 at 8:01 amPost count: 8468
Hemangiomas are a common finding on MRI scans. For the most part, they are benign and don’t cause symptoms. There are some rare aggressive hemangiomas that can expand and weaken bone which would lead to a fracture or even rarer situations that can expand and push against neurological structures, causing neurological deficits. The bone in the hemangioma has a classic “salt and pepper” appearance on CT Scan due to the thickened trabecula through it. Generally, when you say “it appears to me to be more distinct with clear edges in 2019 vs 2018” is an indication that it is benign as clear demarcations without expansion is a good sign.
Have a radiologist review the findings on MRI or CT scan and have them review both studies 1 year apart to determine if there is anything to worry about.
Dr. CorenmanHoleinBoneParticipantMarch 14, 2020 at 2:08 amPost count: 3
Thank you Dr Corenman,
I do intend to meet with a physiologist to look at the results. He may be able to discuss both scans with his radiologist.
FYI, the CT Scan of 2018 does look salt and pepper, whilst the MRI scan of 2019 looks absolutely clear and possibly larger in size with less bone.
Just a couple more clarifications please, is it possible to compare a CT scan with an MRI scan?
Are you saying, an MRI scan will not show the trabecula?
Thanks so much for your insight and knowledge. I am forever grateful to you.
JoyDonald Corenman, MD, DCModeratorMarch 14, 2020 at 9:09 amPost count: 8468
The CT scan is an accompaniment to the MRI but does not replace it. You have to compare apples to apples to understand how changes over time have to be visualized. In fact, it is sometimes more helpful to compare images over time using the same MRI machine instead of different ones. MRIs will not specifically demonstrate the trabecula well in some scans.
Dr. CorenmanHoleinBoneParticipantMarch 15, 2020 at 6:15 amPost count: 3
Thank you. I have to say you are a personal hero of mine. I appreciate the information and facts you share with the public. I feel like patients can suffer so much more by the lack of understanding about their tests, their medical condition and their own bodies. Sharing your knowledge makes you a top-notch human being.
Wish you all the best,
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