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Primary Brain Tumor

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by

Kamal Ahmed

on 11 February 2013

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Transcript of Primary Brain Tumor

This female patient, age 32, was diagnosed August 22, 2011, via a magnetic resonance image, as having a brain tumor measuring 4 cm x 2.5 cm x 2.5 cm, located in the mesencephalon (brainstem) An endoscopic needle biopsy was performed September 6, 2011. The pathologist reported the lesion to be an oligodendroglioma. Oligodendroglioma is an uncommon type of primary brain tumor that comprises about 3% to 4% of all primary brain tumors. In a large study by Cleveland Clinic that involved 1,593 recorded cases of oligodendrogliomas, only six (0.4%) of the 1,593 cases could be found in the mesencephalon, thus demonstrating how rare the tumor is, particularly in that deep portion of the brain. PRIMARY BRAIN TUMOR – Norma Aracely B. The patient rapidly deteriorated into deep coma. A gastrostomy feeding tube was put in her stomach to deliver nourishment, but no treatment was offered for her condition. Oligodendriogliomas located in the brain stem are frequently inoperable, and her doctors regarded conventional chemotherapy and radiation to be of little value in a patient already in deep coma. The photograph below is of the patient on October 24, 2011, (two months after diagnosis), when Dr. Arguello was contacted by the patient’s husband in Saltillo, Mexico, to consider her for ATAVISTIC CHEMOTHERAPY. Her husband took the photo below at the request of Dr. Arguello before treatment was initiated. October 24, 2011 As early as three days after treatment was initiated, the husband noticed that the patient started to open her eyes. The length of time she maintained her eyes open increased with the days following initiation of treatment. The movement of her eyes, however, appeared to have no purpose. October 30, 2011 About 10 to 15 days after atavistic treatment was initiated, the husband noticed more movement in her arms and legs, and the movements were more coordinated: November 5, 2011 About three weeks after initiation of treatment, the husband noticed that the patient followed him or her children with her eyes. The movements of her eyes appeared to have a purpose. November 11, 2011 The patient regained consciousness in the middle of the night, according to the husband. The patient asked for her three children and thanked him for taking care of them. The photograph below was taken around that time. November 20, 2011 "The Anatomy Lesson of Dr. Nicolaes Tulp" is a 1632 oil painting by Rembrandt housed in the Mauritshuis museum in The Hague, the Netherlands. Rehabilitation of the patient was slow due to the marked atrophy of the muscles of her legs and arms. The patient developed several episodes of lung infections, but her doctors in Mexico did not discontinue the use of prednisone as suggested by Dr. Arguello. The patient deteriorated, developing a fungal lung infection. She died in a government hospital in Mexico on February 10, 2012. The patient also exhibited clinical evidence of progression of the brain tumor late in her life. Dr. Arguello believes that several factors played a role in the tragic loss of this patient, after the initial recovery. These factors are: 1 High doses of prednisone employed for long periods of time since her diagnosis of a brain tumor in August, 2011, likely predisposed her to opportunistic infections (particularly of a fungal nature). 2 Due to economic limitations, the patient’s family was dependent upon the government hospital for her care. Thus, while the patient was hospitalized for infections, the atavistic chemotherapy needed to be discontinued since it was not part of the hospital’s treatment protocol. 3 It is also quite possible that the atavistic chemotherapy employed in this patient at that time, October, 2011, was not completely effective for a patient with a brain tumor, because this patient was one of the earliest treated in this manner. Since then, the treatment has changed significantly. Dr. Arguello never personally met the patient, since she lived in a different region of Mexico. Dr. Arguello met the husband in Monterrey, Mexico, where he spoke at a conference on behalf of Dr. Arguello’s treatment.
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