Recurrent Glioma: Fluorescein Fluorescence

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This is another excellent example of resection on the recurrent glioma using fluorescein fluorescence. This is a 46 year-old male who underwent resection of a low-grade oligodendroglioma in the left frontal lobe approximately two years ago. Surveillance imaging revealed tumor recurrence, this time more enhancing associated with assisting component of the tumor compressing the ventricle. The identity of this tumor was consistent with glioblastoma multiforme under final pathology. Patient underwent reopening of the left frontal craniotomy. Fluorescein fluorescence was used to identify the tumor nodule as you can see here. The dura obviously enhances with fluorescein as well as expected. You know navigation was also used for guiding the resection. Fluorescein fluorescence guided this connection of the enhancing nodule away from the surrounding normal peritumoral white matter. There is plenty of light and illumination under the fluorescent module in order to continue dissection. You can see a clear margin of tumor enhancement against the normal white matter. The ventricle, the frontal horn was entered as expected. The cyst was drained. You can see a good resection along the more lateral inferior aspect of our resection cavity. Same can be seen in the more medial part of our resection cavity. I was very satisfied with the extent of resection, which was confirmed using neuronavigation data. Post operative MRI also revealed gross total resection of the enhancing part of the tumor without any complicating feature. Thank you.

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