We still don’t know what it is

This morning L’s surgeon called at eight to talk about the pathology report on the lump he removed from her jaw week before last.  The short answer seems to be that still, nobody knows what it is, although we’re now absolutely certain that it’s not malignant.

He says the thing appears to be either a giant-cell reparative granuloma or a true giant-cell tumor, which is practically unheard-of in skull or facial bones (they occur most commonly in long bones, such as arm and leg bones).  The two are hard to tell apart, but we have to get a definite identification so he knows which of two fairly different courses of treatment are needed.  If it’s a granuloma which is, in his opinion, what it really is, we’re in fairly good shape.  They don’t tend to grow fast, or to grow back once they’re removed, in which case the excision he’s already done should be enough.  If it’s a giant-cell tumor, things get more complicated.  While benign, they’re fairly aggressive growers and require establishment of a safe-zone boundary area between the tumor and clear bone.  Should that turn out to be what it is, he’ll probably have to go back in, remove the ridge of bone he left behind to provide a base for future reconstruction, and carve away more of L’s jaw to establish a DMZ of sorts—in a word, leaving her lower jaw in two widely disconnected pieces that would require grafting to rebuild.  It would also probably require radiation or local chemo treatment to try to blitz out any remaining tumor cells.

He ended up by telling us he’d sent off a sample to a high-powered pathologist at the Mayo Clinic, who’s said to be one of the Authorities on osseous tumors, to get a second opinion.  In the meantime, we wait.

Mae West studied a chocolate teakettle in the gazebo.  Fnord.