Biopsy information

 

Background

Once the mass was confirmed with an MRI (which determined that the boarders were nice, and it wasn't growing on anything), I saw an orthopedist for possible biopsy. He said, based on my MRIs and history, that the tumor is most probably a benign tumor of the nerve sheath, and therefore should be biopsied by a neurosurgeon.

 

It just so happens that Columbia has one of the best neurosurgeons for peripheral nerve tumors. The neurosurgeon met with me relatively quickly, and scheduled my biopsy and possible removal rather quickly. Both orthopedist and neurosurgeon gave me a 5-10% chance of a malignant tumor.

 

Planned surgery

Since the tumor was thought to be a nerve tumor of the tibial nerve, with the nerves spread thinly across the top of the tumor, a needle biopsy couldn't be done. (image of nerves of the leg, showing the tibial nerve) Instead, the surgeon would make an incision a bit bigger than the tumor, and test (using electric current) to see where the nerves were. It was expected to be quite a long process. Once the location of the nerves were known, the surgeon would take a small sample for a frozen section biopsy.

 

Assuming the results of the frozen section test would come back benign, the surgeon would carefully remove the tumor. The tumor could be one of two types (sensory or motor), each with its own removal technique.

 

The real surgery

My parents and Tom were at the hospital with me. The surgeon asked us to show up early (noon), hoping that an operating room might open up early. It turned out that his previous surgery went longer than planned, so my didn't begin until 5:30pm. When he described the surgery to us soon before he started, he said that if the frozen section test can't identify it as benign, he will stop, i.e., leave the tumor in, and carefully close it back up. If this was the case, the surgery would only be an hour.

 

When they first started to bring me out of the general anesthesia, my first thoughts were trying to fight coming out. I was having this really nice dream of riding a yellow bike down a hill very fast, yet feeling very safe. I then noticed that the world was much more blurry than normal; they put petroleum jelly on my eyes. My first question to the nurse who was taking care of my in the recovery room was the time; if it was around 6:30 or 7, then I thought that would mean that the tumor was malignant, or not known yet. Since it was around 9pm, I thought I was safe. But, I thought that I could still feel the tumor (it pushes on my hamstring muscles). Asking the nurse if the doctor took the tumor out only got me the reply "the doctor will speak to you soon." In the standard befuddled state that one is in after a general, I probably asked the nurse 3-4 times about whether the tumor was out.

 

They let my family come to see me, and the doctor came too. (He had already spoken with my family in the waiting room.) He said that the frozen section test showed a type of cells that are not found in benign nerve tumors. He referred to it as cancer.

 

The surgeon mentioned that the surgery took longer than expected because they had problems with the readings to identify where was a good point for the biopsy. For those of you interested: pictures of the incision, taken on 4/7/02 and 4/21/02. It is quite impressive, mostly due to the fact that it is over 5 inches long.

Copyright 2003 The Shriver Family: Last modified: 01/06/04.