Left Temporal Brain Tumors: Symptoms, Treatment, and Prognosis

Brain tumor (left temporal lobe) measuring 5x7x4 cm?

A few months ago, family members began to experience declines in memory and cognitive abilities.
After imaging studies, the doctor diagnosed dementia caused by a stroke.
They have been taking medication, but within less than a month, there has been a noticeable decrease in mobility and the onset of symptoms such as hypersomnia.
A few days ago, an MRI was performed, and the report stated:
Multiplanar imaging pre and post intravenous gadolinium.

1.
There is a 5 x 7 x 4 cm irregular rim-enhancing lesion in the temporal lobe, with significant mass effect.

2.
There is surrounding edema extending to the left posterior parietal lobe.

3.
There is a shift of midline structures by approximately 12 mm, and effacement of the Sylvian fissure and sulci in the left cerebral hemisphere.

4.
There is slight compression of the midbrain.

5.
There is dilatation of the contralateral lateral ventricle.

Impression: Left temporal brain tumor with extensive mass effect as described above.
Is this malignant? Is surgery absolutely necessary? If surgery is performed to remove it, will there be any sequelae?

Alice, 30~39 year old female. Ask Date: 2016/06/12

Dr. Chen Sirong reply Oncology

Alice / 33 years old / Female
1.
Is it malignant?
A1.
A biopsy is necessary to determine if it is truly malignant.
A2.
If it is located in the brain, surrounded by bone, and causing pressure on the cranial nerves, even if the pathology is benign, the symptoms can be unbearable.
2.
Is surgery absolutely necessary?
A1.
The first-line treatment should be surgery.
A2.
If it is benign and can be completely resected, surgery may lead to a cure; why not proceed with surgery?
A3.
If it is malignant, not removing the tumor could lead to symptoms that may not respond well to medication.
A4.
Unless you are willing to accept palliative care.
3.
Will there be any sequelae from surgery?
A: The side effects will depend on the area being removed; it is uncertain to what extent.
You can either accept surgery and its side effects or opt for palliative care and deal with the worsening symptoms that are difficult to control.
4.
Radiation therapy can reduce the recurrence rate after surgery.
If surgery is not performed, relying solely on radiation therapy may not be very effective, but it can be tried if surgery is not an option.
Thank you for your inquiry.
Taoyuan Hospital, Dr.
Chen Sih-Rong

Reply Date: 2016/06/12

More Info

The situation you are describing regarding your family member's left temporal brain tumor is indeed concerning and requires careful consideration of various factors, including the nature of the tumor, potential treatment options, and the associated risks.

Understanding the Diagnosis
Based on the MRI findings you provided, there is a significant mass in the left temporal lobe, which is causing considerable pressure on surrounding structures. The characteristics of the lesion, such as its irregular shape and the presence of surrounding edema, raise concerns about its nature. While the MRI report does not explicitly state whether the tumor is malignant (cancerous) or benign, the presence of significant mass effect and midline shift often indicates a more aggressive process, which could suggest malignancy.

Symptoms and Prognosis
The symptoms your family member is experiencing—declining memory, cognitive abilities, increased sleepiness, and reduced mobility—are consistent with increased intracranial pressure and potential brain dysfunction due to the tumor's mass effect. These symptoms can significantly impact quality of life and may worsen if the tumor is not addressed.

Treatment Options
1. Surgical Intervention: Surgery is often the primary treatment for brain tumors, especially when they are causing significant symptoms due to mass effect. The goal of surgery would be to remove as much of the tumor as possible while minimizing damage to surrounding brain tissue. However, the decision to operate depends on several factors, including the tumor's location, size, and the patient's overall health.

2. Risks of Surgery: Like any surgical procedure, brain surgery carries risks, including infection, bleeding, and neurological deficits. Potential postoperative complications could include changes in cognitive function, speech difficulties, seizures, and motor deficits, depending on the areas of the brain affected by the tumor and the surgical approach taken.

3. Non-Surgical Options: In some cases, if the tumor is deemed inoperable due to its location or the patient's health status, other treatments such as radiation therapy or chemotherapy may be considered. These options can help control tumor growth and alleviate symptoms but may not provide a definitive cure.

Prognosis
The prognosis for brain tumors varies widely based on factors such as the tumor type, grade, location, and the patient's overall health. Malignant tumors generally have a poorer prognosis compared to benign tumors. It is essential to have a detailed discussion with a neuro-oncologist or a neurosurgeon who can provide insights based on the specific characteristics of the tumor and the patient's condition.

Next Steps
1. Consultation with Specialists: It is crucial to consult with a neurosurgeon and possibly a neuro-oncologist to discuss the findings and treatment options. They can provide a comprehensive evaluation and recommend the best course of action.

2. Consider a Second Opinion: If there are uncertainties or concerns about the proposed treatment plan, seeking a second opinion from another specialist can provide additional perspectives and options.

3. Supportive Care: In addition to medical treatment, consider engaging with support services, including physical therapy, occupational therapy, and counseling, to help manage symptoms and improve quality of life.

In conclusion, while the diagnosis of a left temporal brain tumor is serious, timely intervention and a tailored treatment plan can significantly impact outcomes. It is essential to work closely with healthcare professionals to navigate this challenging situation.

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