Exercise #4

The patient was referred to a neurologist after reporting symptoms of vomiting, muscle weakness on one side of the face, and several episodes of slurred speech. The patient had an MRI on June 3, 2004 that showed a glioma in the brain stem. Through an infratentorial craniotomy, tumor was removed on June 30, 2004. The pathology report documented microscopic residual subependymal glioma in the fourth ventricle. On August 1, 2004 the patient had conformal radiation to the fourth ventricle.

Scope of regional lymph node surgery

Radiation treatment volume

Regional treatment modality


Hormone therapy


Hematologic transplant and endocrine procedures