July 7, 2000

Linda Falgiani's doctors in her home state of Oklahoma told her that she would eventually become paralyzed from the waist down and spend the rest of her life in a wheelchair. Luckily for Falgiani, this prognosis probably won't come true.

A resident of Broken Arrow, Okla., Falgiani suffered eight years of numbness and pain in her legs and lower torso. She tried everything to help ease the pain, including devoting hours a day to power walking. Last year, local specialists diagnosed her with an astrocytoma — an inoperable type of spine tumor. With little hope for successful treatment, Falgiani prepared herself for a future of immobility and pain. That was before her son, Michael, then a first-year medical student at the Oklahoma University Medical School, read something that would save Falgiani's life.

At left, Linda Falgiani, with her husband, Larry.

While trying to learn as much about astrocytomas as possible, Michael Falgiani came across an article in the medical journal Neurology by John Henson, MD, executive director of the MGH Brain Tumor Center, about the treatment of spine tumors with chemotherapy. Michael Falgiani called Henson to ask if he would look at his mother's case. Henson agreed, and Linda Falgiani's MRI (magnetic resonance image) and a biopsy sample were sent to the MGH for review.

Because spine tumors are very difficult to diagnose, Henson consulted MGH experts in reading this type of pathology. The team — led by David Louis, MD, of MGH Pathology — determined that Falgiani did not have an astrocytoma but rather had a subependyoma, a rare type of tumor that usually occurs in the brain.

In May, Falgiani and her husband, Larry, came to Boston for consultation with Henson and Lawrence Borges, MD, of MGH Neurosurgery. After a week's worth of tests, Borges and Henson concluded that Falgiani's tumor was, in fact, operable and scheduled her for surgery. On June 7, Falgiani's entire tumor, which had grown to an alarming seven inches long, was removed at the MGH.

"This type of surgery is difficult because the spinal cord is so sensitive to any type of movement," says Borges. "Spine tumors are rare in general, and this type of tumor is exceedingly rare. Fortunately, we were able to remove the entire tumor."

Henson says that he had written the paper for Neurology because of the work that he had done with the Silber family to help develop a formal spine tumor clinic (See "Brain D. Silber Spine Tumor Clinic" in this issue of Hotline). "The Silbers lost their son Brian to a spine tumor and have raised money for a specialized center, which opened in October 1999," says Henson. "I'm pleased that their desire to help create this clinic led me to write this article, which eventually led to the removal of Linda Falgiani's tumor."

While Falgiani was beginning her recovery and rehabilitation at Spaulding Rehabilitation Hospital, she discovered an interesting fact about her family history: Her grandmother, Frieda Baker, attended the MGH nursing program nearly 80 years ago. "It's so funny to think that I never knew this about my grandmother, and here I am, 80 years later, having surgery at the same hospital where she trained," says Falgiani.

Falgiani currently is doing well, and is undergoing rehabilitation at Spaulding. Her prognosis is good, and according to Henson, there is no residual of the tumor.

Falgiani's grandmother, Frieda Baker, who was a student at the MGH School of Nursing 80 years earlier.