Coming back on Sunday evening was hard. I felt fine and I didn’t want to come back to the depressing hospital ward and be emerged again in the nightmare. But I came back, we discussed our doubts but were urged to do the biopsy. I was feeling fine; they had ample time to plan the procedure and nothing needed to be rushed, this was the best, least risky, situation. In the morning before the surgery, I would still speak to my neurologist.
During her visit in the morning, she told me that the lesions resembled lymphoma. The VUmc’s most experienced neuroradiologist had no doubts. The lesions were in such a dangerous location that a small increase in their size could lead to acute problems. The bigger one in the cerebellum could easily cut off the liquor (CSF) circulation, causing hydrocephalus (a waterhead) and other serious problems. They also saw a smaller lesion that is close to the basal ganglia (a selection of important structures in the brain), so they all strongly recommended me to go for the biopsy.
In acute situations, you can reduce the swelling of a tumor or an MS lesion by giving steroids. However, giving steroids could render a biopsy useless. Therefore it was necessary to take the biopsy before they could start with any treatment (note that steroids reduce swelling, but do not treat MS or tumors).