[Tumor] Diagnostic / 2nd Opinion

[singa-traz]

In a recent hospital visit, a lump on my shoulder (clavicle) has been discovered.

Chest X-Ray and Blood test turned normal, then a biopsy was done on the soft tissue mass.

The biopsy reports mention "Spindle-shaped cell tumor", to be further analysed (immunohistochemical study).

A CT scan of the neck and shoulder is scheduled.

As the doctor (Chula) already mentioned that an operation is very likely to remove the tumor, I'm considering a second opinion.

- How do I need to go about it?

- Do I need to redo the same exams again at a different hospital, or only see another doctor with the necessary reports?

The CT Scan is scheduled in a month.

- is that too long? should I look at doing it at a different place?

Thanks for any info.

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[Sheryl]

The urgency of the CT scan will depend upon the final histopathology. Spindle cell tumors can be benign or malignant.

If it is malignant (sarcoma) then it would be good to get the CT sooner, can do so at any private hospital easily. It is quite likely your doctor at Chula has an affiliation with and private practice at, at least one private hospital.

For a second opinion you would need copies of the relevant results and also -- most importantly - a slide with tissue sample. In a case like this it is the pathology report that is most important. Just examining your shoulder and reading reports won't really help much.

Note that with a spindle cell tumor, even if benign, excision is needed, though it can be a smaller procedure than if it is malignant.

This doctor at Bumrungrad and Bkk Hosp is one of Thailand's leading experts in sarcomas

https://www.bumrungrad.com/doctors/Piya-Kiatisevi

https://www.bangkokhospital.com/wattanosoth/en/doctors/index.php?DrID=1067

[singa-traz]

Thanks Sheryl.

[singa-traz]

Got the result of the immunohistochemical study: Schwannoma

So looks like a benign tumor, with slow growth.

Will do the CT Scan at Chula end of the month.

Now reading on the surgery ...

[alyx]

What is the point in waiting

I guess that the one month schedule is due to the queue in Chula

Of course, it is benign, so why not getting rid of it, as soon as you can? If convenient, that is

Edited July 31, 2014 by alyx

[singa-traz]

What is the point in waiting

I guess that the one month schedule is due to the queue in Chula

Of course, it is benign, so why not getting rid of it, as soon as you can? If convenient, that is

Yes, the queue is long at Chula.

I looked at alternative (http://www.mrithailand.com/index.php?lang=en) and can get it done in a week at a similar cost.

Since there is less urgency, I prefer to have all exams in the same hospital, to avoid any potential communication issue.

[Sheryl]

In addition, your scan will require use of contrast media which is best done in a hospital setting rather than a stand alone imaging facility as some people suffer adverse reactions to it.

[singa-traz]

Had the CT-SCAN and a follow-up appointment with the doctors at Chula.

Tumor is about the size of an egg: Schannoma of the Brachial Plexius

Went to see a neurosurgeon at another hospital to get another opinion, and reviewed the CT-SCAN.

Will need an MRI to evaluate the surgery option.

As the symptoms are really rare and mild and temporary, at the moment (small difference in sensation in fingers, numbness and tingling), there is no urgency in the surgery.

Decision is that I will do it within the next 6 to 12 months.

Next step is MRI and a second opinion from another neurosurgeon.

[Sheryl]

That is good news. Recurrences are rare after surgery so you should do fine.