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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

Mets to liver and multiple bones. Dx 11/19/2008, IDC, 1cm, Stage I, Grade 3, 0/1 nodes, ER+/PR+, HER2- Surgery 12/9/2008 Lumpectomy: Left; Lymph node removal: Left, Sentinel Chemotherapy 1/7/2009 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 4/26/2009 Breast Hormonal Therapy 6/5/2009 Dx 11/3/2012, IDC, Stage IV, Grade 3, mets Chemotherapy 11/16/2012 Doxil (doxorubicin) Hormonal Therapy 3/13/2013 Faslodex (fulvestrant) Chemotherapy 9/8/2013 Xeloda (capecitabine)
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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 9/2007, IDC, <1cm, Stage I, Grade 2, 0/4 nodes, ER+/PR+, HER2- Surgery 9/2/2007 Lumpectomy: Left; Lymph node removal: Left Chemotherapy 10/2/2007 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 11/2/2007 Breast Hormonal Therapy 3/2/2008 Arimidex (anastrozole) Dx 9/2014, ILC, Both breasts, 9/13 nodes, ER-/PR-, HER2- Chemotherapy 10/17/2014 AC Chemotherapy 12/29/2014 Carboplatin (Paraplatin), Taxol (paclitaxel) Dx 3/2016, ILC, Stage IV, metastasized to bone, ER-/PR-, HER2- Surgery Mastectomy Radiation Therapy Whole-breast: Breast, Lymph nodes, Chest wall
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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- Surgery 12/9/2008 Lumpectomy: Left; Lymph node removal: Left, Sentinel Chemotherapy 1/7/2009 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 4/26/2009 Breast Hormonal Therapy 6/5/2009 Dx 11/3/2012, IDC, Stage IV, Grade 3, mets Chemotherapy 11/16/2012 Doxil (doxorubicin) Hormonal Therapy 3/13/2013 Faslodex (fulvestrant) Chemotherapy 9/8/2013 Xeloda (capecitabine)
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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- Surgery 12/9/2008 Lumpectomy: Left; Lymph node removal: Left, Sentinel Chemotherapy 1/7/2009 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 4/26/2009 Breast Hormonal Therapy 6/5/2009 Dx 11/3/2012, IDC, Stage IV, Grade 3, mets Chemotherapy 11/16/2012 Doxil (doxorubicin) Hormonal Therapy 3/13/2013 Faslodex (fulvestrant) Chemotherapy 9/8/2013 Xeloda (capecitabine)
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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 9/2007, IDC, <1cm, Stage I, Grade 2, 0/4 nodes, ER+/PR+, HER2- Surgery 9/2/2007 Lumpectomy: Left; Lymph node removal: Left Chemotherapy 10/2/2007 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 11/2/2007 Breast Hormonal Therapy 3/2/2008 Arimidex (anastrozole) Dx 9/2014, ILC, Both breasts, 9/13 nodes, ER-/PR-, HER2- Chemotherapy 10/17/2014 AC Chemotherapy 12/29/2014 Carboplatin (Paraplatin), Taxol (paclitaxel) Dx 3/2016, ILC, Stage IV, metastasized to bone, ER-/PR-, HER2- Surgery Mastectomy Radiation Therapy Whole-breast: Breast, Lymph nodes, Chest wall
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Sep 8, 2014 12:48PM lahela wrote:

This is a really old thread, but I wondered if there was any progress for you or if anyone else was dealing with this? I had a spine MRI last week due to localized pain and radiating pain down my arm, along with reduced strength and reflexes in that arm. Radiologist saw what he thought was a hemangioma, did a CT of the vertebra (T5) and still says hemangioma, but I'm kinda terrified!

Dx 7/2/2013, IDC, 2cm, Stage IIA, Grade 2, 1/1 nodes, ER+/PR+, HER2- Surgery 8/8/2013 Lymph node removal: Right, Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap Surgery 12/11/2013 Prophylactic ovary removal Surgery 12/23/2013 Reconstruction (left) Surgery 3/3/2014 Reconstruction (left); Reconstruction (right) Surgery 6/23/2014 Reconstruction (left): Nipple reconstruction; Reconstruction (right): Nipple reconstruction
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Jan 22, 2016 07:50PM - edited Jan 22, 2016 07:59PM by Kksauze

Hello ladies, it's been a while since anyone posted here. I have been in remission for about 1 1/2 years and am suffering quite a lot with neck and back pain since August last year. In June I had a PET for lingering cough and that didn't show malignancy, only the radiation pneumonitis of right lung, when the headaches and neck pain started in early August I had an MRI, which came back with mild cervical degeneration and a hemangioma at the neck. I had Physical therapy for two months and meds and it only seemed to get worse. Back pain between shoulder blades is awful and it wakes me up at night. Another MRI done a couple days ago and no change from previous at the neck but several other hemangiomas at the spine, no malignancy, but months of pain make me worry. This can't be normal. Anyone of you experience the same? Is it possible mets can be mistaken for hemangiomas even in an MRI? Ribs on right side are weak, they fracture easy and right hip nagging pain, but onco Doctor seems to believe nothing is wrong. I had a very difficult treatment; I found out about the cancer and pregnancy on same day, and I was warned it would be risky to carry the pregnancy because of all the hormones that I'd be making that could feed the cancer. Now this haunts me. I am so discouraged.

Thank you for your time!

K

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Jan 31, 2016 12:05PM Jumpship wrote:

bump

Negative for 16 of 17 gene markers. Positive for NBN-marker of unknown significance. Dx 7/2/2014, IDC, 2cm, Stage II, Grade 3, 0/4 nodes, ER+/PR+, HER2+ Surgery 9/30/2014 Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Targeted Therapy 11/21/2014 Herceptin (trastuzumab) Chemotherapy 11/21/2014 Carboplatin (Paraplatin), Taxotere (docetaxel)
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Feb 8, 2016 02:00PM Allydp wrote:

I just stumbled across this post and thought I'd share my experience.

I had a lesion on my sternum light up on my MRI at initial diagnosis. My medical team was divided whether or not it was mets, so I had a bone scan and PET. Both were clear and it was deemed a benign tumor. However, a few weeks later I read my report on my patient portal and was stunned to learn that same MRI also revealed 2 atypical hemangiomas on my spine. The verbiage clearly stated they were suspicious of mets. When I asked my MO and BS, they both said that because neither showed up on the bone scan or PET they weren't concerned and no follow up was needed.

I just couldn't let it go. I finally ended up getting a 2nd opinion at another hospital and requested a follow up scan to ensure no change. They looked at my MRI and agreed to the scan. All 3 areas showed no change and the they were definitely cleared as benign at that point.

I also have lots of pain in my back in the exact area of these darn hemangiomas. I also have pain underneath my shoulder blades, posterior ribs and bouts of nerve pain down both legs. The follow up scan helped me to move on from the worry of them being mets, but the pain definitely plays tricks with me and makes me second guess! So you ladies are not alone in this!

K - could you see an orthopedic surgeon regarding the back pain and easily fractured ribs? They might be able to do a work up and hopefully give you some peace of mind.


Alicia - Dx at 33, BRCA2+ Dx 1/30/2014, IDC, 2cm, Stage IIA, Grade 3, 0/2 nodes, ER-/PR-, HER2- Surgery 2/5/2014 Lymph node removal: Sentinel Chemotherapy 2/25/2014 Adriamycin (doxorubicin), Carboplatin (Paraplatin), Cytoxan (cyclophosphamide), Taxol (paclitaxel) Surgery 8/16/2014 Mastectomy; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 12/8/2014 Prophylactic ovary removal Surgery 1/20/2015 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant

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