Case 1: Informed Consent for Surgery

Mr. GB was admitted to the neurosurgical ward 5 days ago, and he has had some radiological examinations. Today, I'll tell him the results of the examinations and explain the surgical operation to him.

(In the quiet room.)


Based on your MR images, we should consider the possibility of a brain tumor or a brain abscess. The result of the MR spectroscopy shows that the possibility of a brain abscess is extremely low. You have no medical history of any cancer and your whole body CT shows no evidence of any cancer. Thus, we should suspect that the mass is a primary brain tumor. Besides, the mass is enhancing and has wide area of edema. These are features of high-grade gliomas.
As a first step of the therapy, we should remove as much of your brain tumor as possible. The tumor cells are invading the normal brain tissue, so we can't remove them totally. The tumor is located adjacent to the very important area of your brain, which is the center for moving your right hand and output of speech. We use some special instruments to avoid causing any damage to those important areas, but we cannot always be certain.
The estimated length of the surgery is 5 hours. After the operation, neuropathologists will make the exact diagnosis. You will receive radiation and chemotherapy after the operation. I will explain the dose of radiation and kind of chemotherapy later, because they depend on the pathological diagnosis.