Wellington Case Report. Intrinsic left insula mass lesion

                                                                                         

 

MEDICAL REPORT

Q.A, 75 YEARS, FEMALE


 

Diagnosis- Intrinsic left insula mass lesion

 

Management plan – Stealth guided biopsy

                                  Adjuvant oncology treatment

 

 

 The above named patient is a 75yrs old presenting with recurrent seizures last was Dec 2022. Seizures is generalized tonic with impairment of consciousness that lasted up to 2-3 hours. No loss of urinary or bowel functions, no headache, no weakness of upper and lower limbs. She is quite ambulant.

She is hypertensive controlled with medications. She also has bilateral osteoarthritis. Following the last episode of seizure while she was in vacation in UK had a brain can which reveals intrinsic tumor. Subsequently placed on reducing dose of dexamethasone and keppra. She has been stable since then but added some weight due to intake of dexamethasone.

In the clinic today, she walked in by herself accompanied by her daughter.

Following the above complains she had neurological assessment which confirmed normal cranial nerves (1-12). Normal fundoscopy on the neuro mutualizing sense.

MSS- confirmed crepitations feelings on bilateral knee joints suggesting OA.

 

We had the opportunity of reviewing MRI today (07/02/2022) recon ducted in our hospital because of inability to open the previous one.

Radiological Imaging:

MRI Brain confirms as previous report significant changes in the region of left insula and adjacent temporal lobe (opercular region). It takes up contrast poorly and hypo intense on T1. This feature suggest astrocytoma probably transiting from grade 2 – grade 3.

Diagnosis was explained to the patient basic understanding and the need for minimally invasive neuro- navigational assisted biopsy of lesion discussed with patient and we will be happy to proceed with the procedure as soon as consent is obtained.

 

 

 

Management Plan

·         To continue tabs dexamethasone 2mg B.D

·         Counselled on stealth guided biopsy

·         For stealth biopsy

 

Kindly revert for further clarifications if need be.

 

 

Sincerely yours,

 

 

 

Dr. Halima Ibrahim

For Team Wellington Clinics.

17 Jul, 2023
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