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All TopicsForum: Not Diagnosed with a Recurrence or Metastases but Concerned → Topic: Vertebral Hemangioma vs. bone mets

Topic: Vertebral Hemangioma vs. bone mets

Forum: Not Diagnosed with a Recurrence or Metastases but Concerned — Meet others concerned about developing a recurrence or metastases.

Posted on: Oct 24, 2009 12:05PM

marymoir wrote:

Turning once again to this wonderful community for advice/support.

 I have been experiencing numbness in my left cheek, arm, and hand for about 3 mos.  Onco sent me for a brain MRI, which was clean., so he sent me to a neurologist, who ordered an MRI of my cervical spine. Neuro called me to give me the results (always wonder if it's a good or bad sign when the doctor calls as vs. the nurse!!)  She said that the scan showed what appeared to be hemangiomas in my T2 and T3 vertebra, & explained that those usually are benign vascular tumors unrelated to my breast cancer.  However, the radiologist indicated that mets could present a similar appearance on MRI, so she wanted me to have a CT scan.  When the nurse called to schedule it, I asked her to send me a copy of the report.  It says:

"Hyperintense T1 and T2 signal with contrast enhancement is present within the vertebral bodies of T2 and T3.  The signal does not surpress on the fat-surpressed sequences.  This may represent atypical hemangiomas however metastatic disease could have a similar appearance.  Consider further evaluation with CT scan of the cervical spine."

So of course I decide to play radiologist & go trolling the 'net yesterday trying to find something that will tell me that the radiologist's description is more typical of hemangioma than mets, and find an article that says hemangiomas are dark on fat supressed sequences, but mets stay lit up with fat supression.   However, it also says that hemangiomas are bright on both T1 and T2, while mets are dark on T1.  So my attempt to play radiologist just made me more confused.

I scheduled the CT at the same time they're doing a lumbar puncture (to rule out leptomeningeal mets), but unfortunately that means I have to wait 5 days.  So of course I'm freaking out playing the waiting game.   Anyone else out there had this type of situation where they are trying to distinguish b/w spine mets and hemangiomas???  Please share, whatever the results were, good or bad.

 Thanks!

Mary

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Oct 24, 2009 04:40PM SoutherMother wrote:

Can you possible get a PET/CT scan instead of a plain CT scan. This all seems similar to my case.  Except that I had a PET scan that showed a high SUV value (6.3) that went up in the next PET scan to 7.2.  Then it went hypermetabolic (9.0?) on the next scan along with some back ache symptoms.  My Neurologist was sure it was cancer but Oncologist was not 100% without a biopsy.  Did two biopsies (total of six pokes into my T-8) without catching the cancer on the samples.  But the lab report has all the descriptions of what cancer looks like in those biopsies, it just wouldn't stain for cancer(s).  The cancer board all agreed that a low dose of radiation should help control its intensity and growth.  Sure enough, had radiation, which left the next PET scan showing no hypermetabolic activity in T-8.  I keep trying to believe it is a hemangioma but the Oncology Radiologist, Radiologist, Oncologist and Neurologist say no, it is not the case. My medical records call it metastatic cancer and that I am stage four, but I hold out that it is a hemangioma.  Are your lesions in the posterior or anterior of the vertabrae?  I would have to look it up in my notes but cancer tends to be in one but not the other.  Please let us know how it turns out.

Dx Sep 2007, IDC, Stage1, .9cm, Grade 1-2, 0/4 nodes, ER+PR+HER2-

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Oct 24, 2009 11:56PM marymoir wrote:

Southermother --

 Thanks for the reply!  Sorry to hear what a nightmare you've been through, but glad to hear that your (met/hemangioma??) is stable.  Don' t know which part of the vertebrae since all I have is the written radiologist's report, which doesn't say.  But your post made me realize that I don't know if my onc knows about the MRI results, so I should check to see if he wants me to have any other imaging done at the same time ast the CT.  (already have a lumbar puncture scheduled that day to rule out leptomeningeal mets, might as well make a day of it LOL!!)

I'll let you know what I find out

Mets to liver and multiple bones.

Dx 11/19/2008, IDC, 1cm, Stage I, Grade 3, 0/1 nodes, ER+/PR+, HER2-Dx 11/3/2012, IDC, Stage IV, Grade 3, metsSurgery 12/09/2008 Lumpectomy (Left); Lymph Node Removal: Sentinel Lymph Node Dissection (Left)Chemotherapy 01/07/2009 Cytoxan, TaxotereRadiation Therapy 04/26/2009 ExternalHormonal Therapy 06/05/2009 TamoxifenChemotherapy 11/16/2012 DoxilHormonal Therapy 03/13/2013 FaslodexChemotherapy 09/08/2013 Xeloda
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Nov 5, 2009 07:00PM marymoir wrote:

Update --

Had a CT last week of the area which had the lesions.  My oncologist wasn't able to weigh in before the scan to indicate whether he tought a PET should be combined, so just had the CT.  Radiologist's report on the CT scan came back w/ the same "CYA" language to the effect that they were probably just hemangiomas, but couldn't entirely rule out mets. 

Just got a call from onc's office -- they asked if I was having any pain in my back (no, just numbness in arm/hand/cheek).  Onc thinks we should just watch the spots unless they become symptomatic (ie., I start getting pain in that area of my back).   He said that if it is mets, it will eventually cause pain due to bone destruction. 

 Sounds rather utilitarian, but kind of glad to be given permission to "get on with my life."  Before last week's lumbar puncture fiasco last week, I would've been demanding a PET scan.  As it is now, I like the idea of just assuming they are hemangiomas.  I'm so busy w/ work/kids that I'm going to worry about that stuff (at least, until the next little ache or pain comes along LOL).  Happy to take a break from tests for a while!!

Mets to liver and multiple bones.

Dx 11/19/2008, IDC, 1cm, Stage I, Grade 3, 0/1 nodes, ER+/PR+, HER2-Dx 11/3/2012, IDC, Stage IV, Grade 3, metsSurgery 12/09/2008 Lumpectomy (Left); Lymph Node Removal: Sentinel Lymph Node Dissection (Left)Chemotherapy 01/07/2009 Cytoxan, TaxotereRadiation Therapy 04/26/2009 ExternalHormonal Therapy 06/05/2009 TamoxifenChemotherapy 11/16/2012 DoxilHormonal Therapy 03/13/2013 FaslodexChemotherapy 09/08/2013 Xeloda
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Nov 5, 2009 08:09PM SoutherMother wrote:

Glad to hear that you are moving on with the other worries of life.  Hope the spots stay quiet and eventually prove to be hemangiomas.

Dx Sep 2007, IDC, Stage1, .9cm, Grade 1-2, 0/4 nodes, ER+PR+HER2-