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Old 04-22-2012, 12:32 AM #1
MClive MClive is offline
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Help MS Lesion Enhancing 6 months...should we biopsy?

I have a T2 hyperintense white matter lesion that has been solidly enhancing for over six months. Doctors are now thinking they might have missed something in my diagnosis, and are talking about a biopsy. Its a 38mm lesion, so I'm definitely in favor of making sure we haven't missed the diagnosis, but just wondered what everyone else has heard or experienced when it comes to persistently enhancing lesions.

Has anyone had or heard about MS lesions that enhance beyond six months? I have researched it and I know its possible in about 2% of MS cases, but I just wanted to see if anyone has actually come across this, and if it is more (or less) common than reported.

As far as treating my lesion, I have had three rounds of solumedrol (five days at 1,000mg plus a 4 week prednisone taper in November/3 days at 250mg in Feb./3 days at 1,000mg in March). I have also done five days of plasmapheresis. Nothing seems to be touching this lesion. It enhances as strongly now as it did six months ago.


I'm happy to give more details about anything, so feel free to ask.

Thanks in advance for any help!

Mandy
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Old 04-22-2012, 10:47 AM #2
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How scary Mandy, I'm glad your Doc is on it though. I would be interested to know what you find out about this. What I know about lesions and what causes them, you could put on a post-it-note.

I do know that when a lesion is enhanced, it usually means that your MS is active and you are probably having a flare. As for the length of time it stays active, I'll leave that to the scientists.

It may also have to do with the type of MS you have. Maybe yours is a more progressive type??

I hope it stops inhancing, goes away and you feel better soon.
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Old 04-22-2012, 08:03 PM #3
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Hi Mandy,

I don't have a clue about this. Just wanted to say I'm here and I care.
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Old 04-23-2012, 05:51 PM #4
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hi mandy,

38mm sounds large to me, too large for an MS lesion??? i don't know.
can you get a 2nd opinion? see another radiologist?

i'd like to know what it turns out to be.
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Old 04-23-2012, 08:47 PM #5
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Hi Mandy,

I had one initial lesion in my brain that enhanced for more than a year. A year later, I developed several brain stem lesions that enhanced for more than 2 years. My docs wanted to do a brain biopsy too but I was not too keen. The lesions were not easy to reach and the risks were very high.

I will tell you that I still do not have a diagnosis after 8 years. I had a MS diagnosis for 1 year but it was revoked. I am thought to have a CNS vasculitis. I decided against the biopsy as I felt and still feel strongly that time would reveal the answer. The were more cons than pros.

Why have your docs felt the need to treat the lesion so aggresively? Are they treating symptoms or the lesion?

Good luck. I wish you the best.

Pacifica
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