Diagnosis
Residual tumor of the right temporal lobe. Status post-partial tumor resection.
Patient:
Adolescent, 15 years old, Kazakhstan
Physician:
Prof. Dr. med. Martin Scholz, Head of Neurosurgery Department, Sana Hospital Duisburg
Patient’s Complaints:
Localized symptomatic epilepsy and epileptic syndromes presenting with simple partial seizures.
Expert Opinion by Prof. Martin Scholz:
We are evaluating a residual tumor located in the right temporal region.
The provided MRI scans also reveal suspicious contrast-enhancing structures in the insular cortex. Whether a second surgical intervention is indicated depends primarily on the definitive histopathological diagnosis of the previously resected tissue. What were the exact histology results? Is the lesion a glioma? If so, what grade of malignancy was established?
If surgery is clinically indicated, we can perform a complete resection of the residual mass utilizing fluorescence-guided microsurgery, real-time intraoperative ultrasound monitoring, and continuous neurophysiological monitoring (evoked potentials).
However, reviewing the official histopathological report is an essential first step.
Patient’s Reply & Inquiry:
According to the pathology report, the diagnosis is a Dysembryoplastic Neuroepithelial Tumor (DNET), simple form, WHO Grade I.
- Is it possible to achieve a complete resection of the residual tumor? Our local oncologists are currently recommending chemotherapy.
Doctor's Response:
Given this diagnosis, we strongly advise proceeding with a second surgical intervention. The residual tumor can be completely removed.
The rationale for chemotherapy in WHO Grade I lesions is highly questionable. To address this specific aspect, you may consult Prof. Dr. med. Marc Remke, Head of Pediatric Oncology at Düsseldorf University Hospital. In all likelihood, chemotherapy will be unnecessary if complete surgical resection is achieved.
Preliminary Cost Estimate: €25,000