Heterogeneous, enhancing, intramedullary lesion

I had an MRI that shows a Heterogeneous, enhancing, intramedullary lesion, 3cm in size on the head of my humerus. I can't seem to find out just what this term means. I had the lesion radiated a month ago, it continues to be irritating. I have had a lytic lesion on my L5 for five years. Would this be similar in nature? Help!

[LearnAll]

If you look at the diagram of cross section of your long bones , you will notice that there are 3 concentric circles....the outermost one is solid bone (called Cortex) Middle one is trabeculated ,spongy type bone (called Medulla) and the inner most one is a hollow space which houses bone marrow.

Therefore, intramedullary lesion means that cancer cells have invaded the outer two layers..cortex and medulla. This lesion needs to blown up to prevent it from reaching bone marrow .

[Hidden in reply to LearnAll]

In your opinion, do you think that the radiation that was done had the effect of preventing the lesion from reaching the marrow?

[LearnAll in reply to Hidden]

yes. Radiation basically burns the cancer cells and thus, killing them so they can not continue to corrode deeper . Bone marrow is deep inside the bone and only reachable by cancer cells if they succeed in penetrating cortical as well as medullary parts of bone.

Tall A is right in saying that both lytic and blastic lesions are capable of reaching bone marrow. However, lytic lesion are more destructive than blastic lesion as in blastic lesion, body is still trying to make new bone cells and attempting to thwart invasion.

Getting the lesion irradiated may not kill 100% cancer cells but will kill a lot of them to prevent further damage.

[Hidden in reply to LearnAll]

Thank you! You and Tall_Allen just took a tremendous amount of stress off me. I should have mentioned that I also just began (12-18) Zometa infusions.

[Tall_Allen]

How much radiation did you get to the lesion? They can sometimes give a second dose for pain palliation.

[Hidden in reply to Tall_Allen]

13. Once. I'm still wondering just what type of lesion I have and did the radiation "stop" it. As noted above I have had a lytic lesion on my L5 for five years. It remains stable. In your opinion Tall_Allen, in laymen terms, what type of lesion is this and did the radiation do it any good. I understand that a lytic lesion has marrow involvement, Am I correct in that assumption? Thank you.

[Tall_Allen in reply to Hidden]

If it's still causing pain, ask your RO if you can get a repeat dose. One or two doses usually gives good local control. Any bone met, lytic or blastic, can penetrate to the marrow if it goes long enough. But stopping progression doesn't reverse the damage that was done to the bone tissue. A bone strengthening agent (Zometa or Xgeva) may help (and it's probably a good idea to take Celebrex with it).

[dadzone43]

Those are simply descriptors of the image and what contrast does to it (enhances) in the medullary (central) portion of the humeral (armbone) head with a mixed (heterogenous) appearance of the shadows. Doctors love their Greek. You have an "ow-ie" in your armbone.

[Hidden in reply to dadzone43]

Thanks for the reply. would you know what the medical term "intramedullary lesion" means? Thank you.

[dadzone43]

Yes. bone has three levels. The medullary level is the deep level where bone marrow lives. "Intra" means inside.