A 60-year-old female with a history of hypertension presents with progressive weakness in her right arm and difficulty speaking. MRI shows a mass in the left frontal lobe. What is the most appropriate next step in management?
- A) Observation
- B) Surgical resection ✓
- C) Radiation therapy
- D) Chemotherapy
The most appropriate next step in management is typically B) Surgical resection.
Explanation:
- Clinical Presentation: The symptoms of progressive weakness in the right arm and difficulty speaking suggest that there may be an underlying lesion affecting motor function and speech centers, which are located in the left hemisphere for right-handed individuals (and often for left-handed individuals as well).
- Imaging Findings: The MRI findings indicating a mass in the left frontal lobe raise concerns for possible brain tumors such as gliomas or metastases. Given the patient’s age and symptomatology, immediate intervention is warranted.
- Management Protocol: In cases where there is a space-occupying lesion causing neurological deficits, surgical resection is often indicated to relieve pressure on surrounding brain tissue, obtain histological diagnosis, and potentially achieve curative treatment if the tumor is resectable.
- Further Treatment Considerations: While radiation therapy and chemotherapy may be necessary depending on the type of tumor identified post-surgery (e.g., if it’s a malignant glioma), these treatments are generally considered after surgical evaluation and intervention.
- Guidelines & Recommendations: Clinical guidelines from neurosurgical associations advocate for surgical intervention as a first-line approach when feasible, especially when neurological deficits are present.
