Thalamic glioblastoma. What to do?
Έγινε ενημέρωση: 10 Δεκ 2020
Thalamus presents a challenge for neurosurgeons. As a deep seated lesion indeed, thalamic glioblastoma raises concerns wether it is better to do a resection or a biopsy in order to avoid approach related morbidity.
Here you see a contrast enhancing lesion in the left thalamus of a 60 year old patient in very good clinical condition, most probably a glioblastoma.
The problem is that without tumor removal at all, the prognosis of the disease is extremely limiting. We went for a microsurgical removal of the tumor via a left parietal mini-craniotomy, parasulcal (medially to the intraparietal sulcus) approach to the ventricular atrium and identification of the choroidal plexus. The tumor removal was facilitated with CUSA aspirator. The postoperative MRI shows almost gross total resection of the tumor; most contrast enhancement represents choroidal plexus. Histology confirmed glioblastoma. The patient was neurologically intact and could leave hospital 5 days after surgery.