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Q. I have had nausea, vomiting, and left-side cluster headaches for one year. Is there a suspicion of neoplasm?

Answered by
Dr. Seyedaidin Sajedi
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Sep 14, 2022 and last reviewed on: Sep 20, 2022

Hi doctor,

Can you please review my brain and neck MRIs?

What do you think concerning my symptoms of nausea, vomiting, and left side cluster headaches for one year?

Please also review the dural calcification and T2 hyperintensities, as well as the right side supraclavicular or posterior lymph node.

Is there a suspicion of neoplasm?

I have had one year of unexplained nausea, vomiting, and cluster headache.

I have done the following laboratory tests:

MRI and blood tests showed slightly elevated RBC count, hematocrit, and GFR of 70 mL/min.

I am currently not on any medication.

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#

Hi,

Welcome to icliniq.com.

I understand your concern.

From the reports attached (attachment removed to protect the patient's identity), I saw a suspicious intensity in the right parietal area. But I could not see (or open) the sequence with contrast. Therefore, to give a neurological opinion about your headache, I need the radiology report of your brain MRI (magnetic resonance imaging).

Hi doctor,

Thank you for the reply.

I have given access to the contrast files.

Could these screenshots of the post-contrast brain view tell you anything?

What does auspicious mean as it relates to hyperintensity?

#

Hi,

Welcome back to icliniq.com.

I understand your concern.

I have read the radiology report and reviewed your new images (attachment removed to protect the patient's identity).

The reported small hyperintense lesions are not clinically important.

To determine the exact nature of the hypointense lesion in the right frontoparietal area, you must undergo a brain CT (computed tomography) scan.

Hi doctor,

Thank you for the reply.

Does it require further investigation, such as a CT, or is it more likely to be benign, as reported in the initial finding?

Are there suspicious features to this lesion that could indicate a meningioma or other tumor activity?

I am worried that the initial report from the radiologist may have dismissed this as normal calcification when it may be something else.

#

Hi,

Welcome back to icliniq.com.

I understand your concern.

I agree with your radiologist that the round suspicious intensity in your right frontal area, with a high possibility, is a calcified lesion. Brain calcifications are mainly benign.

However, MRI (magnetic resonance imaging) can technically not create an image from calcium. Moreover, the images did not show specific enhancement of meningioma. So, to be 100 % sure that it is calcification, we need an imaging technique that can show calcium effectively, and it is CT (computed tomography) scan. Because of this, I recommend you undergo a brain CT scan (without contrast) to be sure it is a benign calcified lesion.

Hi doctor,

Thank you for the reply.

I have scheduled a CT and neuro follow-up. Worst case scenario, and just out of curiosity, what are some diagnoses that a CT could show, a specific type of calcified tumor?

If this is indeed just a benign brain stone, is there any chance it may be causing symptoms, and do people ever need to have them removed?

#

Hi,

Welcome back to icliniq.com.

I understand your concern.

The brain CT (computed tomography) can tell us whether it is calcification or not. However, it cannot give more data than MRI (magnetic imaging resonance). You do not have to do anything if it is a calcified lesion.

Calcified lesions are benign. In some rare cases, the lesions may cause seizures. If medical treatment is not enough, surgical resection would be needed.

Hello doctor,

I did go ahead and get the CT scan. As suspected, it is calcified, but how can I be sure it is not a calcified benign tumor? I have heard of massively calcified slow-growing tumors and want to be sure.

#

Hello,

Welcome back to icliniq.com.

I saw your brain CT. Do not worry. It is a completely calcified benign lesion. A completely calcified lesion will not grow. Therefore, forget its presence and enjoy your life.


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