To report a case of gross total resection of an IDH-mutant Grade 3 astrocytoma located in the medial orbitofrontal area using a minimally invasive supraorbital keyhole approach.
Approach:
Surgical Technique: A minimally invasive supraorbital trans-eyebrow craniotomy was performed under microscopic guidance, utilizing intraoperative neuronavigation to ensure accurate tumor localization and minimize cortical exposure.
Key Findings:
The patient underwent gross total resection with no residual tumor detected on early postoperative MRI.
Histopathological examination confirmed the diagnosis of IDH-mutant Grade 3 astrocytoma.
The patient subsequently received standard adjuvant radiochemotherapy with temozolomide.
The patient experienced preserved neurological function and high cosmetic satisfaction postoperatively.
Interpretation:
The supraorbital keyhole approach can provide oncologically adequate resection of medial orbitofrontal IDH-mutant high-grade gliomas while minimizing surgical morbidity.
Limitations:
The case report is based on a single patient, limiting generalizability.
Long-term outcomes and recurrence rates are not discussed, which may affect the overall assessment of the surgical approach.
Conclusion:
This case demonstrates the feasibility of the supraorbital keyhole approach for resecting high-grade gliomas in challenging locations.
