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Clinical Report

Right parietal Glioblastoma, WHO Grade IV

Dr. Michael R. Chicoine, Associate Professor, Neurological Surgery
Washington University School of Medicine & Siteman Cancer Center
Barnes Jewish Hospital, St Louis, Missouri

PATIENT INFO: 60 year old male patient

SUMMARY: This patient presented with a large right frontoparietal intra-axial mass. For this reason the surgeon elected to perform an awake right frontotemporal parietal craniotomy with language and motor mapping. Image-guided resection of the tumor was carried out with the patient awake. Afterwards the patient was placed under anesthesia with his airway protected with a laryngeal mask airway. An intraoperative MRI was then performed which showed an area of residual enhancement in the anterior rim of the resection cavity. The intraoperative MRI scans were then transferred to the surgical navigation system and used to locate the area of residual enhancement which was then removed. Biopsy samples obtained prior to and after intraoperative MRI were identified as glioblastoma, confirming that the additionally resected tissue was indeed tumor.

In this case, intraoperative MR images identified and precisely located an area of residual tumor that was then removed with additional resection.