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Findings from Dec. 13 Surgery

Per MRI scans from during 2017, a cyst slowly formed and was growing  in a resection cavity, the one in the right temporal lobe. The cavities don't go away. Normally, they sit there filled with cerebrospinal fluid. There's also at least one much smaller cavity, simply formed by Gamma Knife radiation, literally a hole burned in.

Sitting in the office one morning following an MRI scan in October, I got a voice mail that I had a referral to my neurosurgeon. This was news to me, I hadn't talked to anyone yet after the scan. During the visit, he said the cyst, of unknown composition, would need to come out sooner or later. It had filled just about the whole cavity and was going to be pressing on the cavity walls very soon. But it wasn't something that needed to be done urgently, say, next week. He gave me the choice of some dates in December, I picked the 13th. He said to call him right away if weird things started happening on my left side.

I'd forgotten how long recovery takes after neurosurgery, even for one he said was an easy operation. It probably was a straightforward procedure for him. He drained the cyst, which was a bunch of blood byproducts and waste. He took out the tissue inside the cyst which presumably was emitting the waste that was filling it. He also removed some black spots on the cavity wall/dura. He thought it was probably melanoma.

[A few years ago I had read about radiation effect, aka treatment effect, and how it could crop up many years later. Some people need a neurosurgery years later to deal with it. Not all locations in the brain are easily accessible, however. Radiation can be directed anywhere, but surgery in some locations can be problematic or even not possible.]

This procedure was at the site of a previous surgery, so it was definitely accessible. The pathology report came back as "no metastatic melanoma is identified." For the sample pieces submitted of the cyst, 1.4 x 1 x .4 cm in aggregate, the report says, "Necrosis and reactive changes compatible with treatment effect. No metastatic melanoma is identified." For the a 2 x 1.9 x .1 cm fragment/sample of the dura with black markings from the cavity wall, it says, "Dura with dystrophic calcification." Meaning both of these were very likely long-term 'treatment effects' resulting from radiation treatment in 2011.

There are a couple of things I am relieved about. But the bottom line for this is, no melanoma found in those samples.

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