Diagnosis
WHO Grade I brain astrocytoma.
Patient:
Child, 3 years old, Kazakhstan
Physician:
Prof. Dr. med. Martin Scholz, Head of Neurosurgery Department, Sana Hospital Duisburg
Expert Opinion by Prof. Martin Scholz:
The long-term prognosis for Grade I astrocytoma depends heavily on achieving complete surgical resection of all tumor tissue. The provided MRI scans reveal residual tumor tissue located adjacent to the right medulla oblongata, directly beneath the facial nerve pathway. This residual mass is amenable to surgical removal.
However, to safely resect this portion, I would advise utilizing a different surgical approach than the midline trans-craniotomy used in the initial procedure—which was entirely appropriate and well-executed for the primary resection. While we would initiate the procedure via the prior surgical corridor, a purely midline approach limits visualization of the facial nerve and the medial aspect of the brainstem. A lateral approach provides direct visualization and continuous control over these sensitive anatomical structures.
We perform these delicate procedures using real-time intraoperative neurophysiological monitoring. I am confident in our ability to perform this surgery safely, with a high probability of achieving complete tumor removal.
Preliminary Cost Estimate: €29,000.