Complete Excision Of Tumor Research Articles

Chondroblastoma of the occipital bone with aneurysmal bone cyst: A rare case report.

Chondroblastoma is a rare, benign bone tumor originating from immature chondrocytes, typically found in the epiphyseal plates of long bones. Its occurrence in the skull, particularly the occipital bone, is extremely rare. We report a 10-year-old girl presenting with paroxysmal dizziness, occipital pain, and a palpable mass. Imaging studies revealed an osteolytic lesion in the occipital bone with a multiloculated appearance, indicating a concomitant aneurysmal bone cyst. The patient underwent craniotomy with complete tumor excision. Postoperative follow-up showed no neurological deficits or complications and MRI confirmed no recurrence. This case highlights the rare presentation of occipital bone chondroblastoma and emphasizes the importance of early surgical intervention for positive outcomes in pediatric patients.

Extended Endoscopic Endonasal Approach for Tuberculum Sella Meningiomas: Lessons Learned

Midline meningiomas arising from the anterior skull base, particularly the planum sphenoidale and tuberculum sellae (TSM), present unique challenges due to their proximity to vital structures such as the optic apparatus. Traditionally approached via transcranial routes, these lesions often lead to chronic compression of optic nerves, resulting in visual impairment. With advancements in endoscopic skull base surgery, extended endonasal endoscopic (EEE) approaches have emerged as a viable alternative. This study aims to analyze the technical nuances and outcomes of EEE approach for excision of anterior skull base meningiomas presenting with visual impairment. Thirteen patients with TSM and visual impairment underwent EEE surgery at a single institute. Clinical, radiological, and ophthalmological evaluations were conducted pre- and post-operatively. Surgical techniques involved meticulous tumor excision, preservation of vital structures, and multi-layer skull base reconstruction. Visual outcomes, extent of resection, complications, and endocrine function were assessed. The study demonstrated significant visual improvement in 76.9% of patients, with no cases of permanent visual deterioration. Complete tumor excision was achieved in the majority, with near-total excision in selected cases due to adhesions or tumor characteristics. Complications included CSF rhinorrhea, meningitis, and transient visual field defects, all managed effectively. Endocrine function remained largely unaffected postoperatively, except for one case of diabetes insipidus. The EEE approach offers distinct advantages in accessing and excising anterior skull base meningiomas, particularly in achieving optic nerve decompression while preserving vision. Despite challenges associated with larger tumors and adhesions, careful surgical planning and techniques can optimize outcomes. This study contributes to the growing evidence supporting the efficacy and safety of EEE approaches in treating anterior skull base meningiomas, emphasizing the importance of surgical expertise and patient selection.

A 24-kilogram retroperitoneal liposarcoma surgical management: A case report

Sarcomas are diverse malignant tumors originating from soft tissues (STS) or bones, with STS being more prevalent. Liposarcoma is the most common type of STS, typically arising in the extremities and retroperitoneum. This case report discusses the management of a rare, giant retroperitoneal liposarcoma (RL) in a 47-year-old man presented with significant abdominal enlargement, post-pharyngeal discharge, and urinary dribbling. Medical history included an inguinal hernia and smoking. Diagnosis through imaging (sonography, CT, MRI) and biopsy confirmed a well-differentiated liposarcoma encasing the left kidney and compressing abdominal organs. The tumor measured 53 × 47 x 20 cm and weighed 24 kg. Surgical management included complete tumor excision, left nephrectomy, iliac artery repair, colectomy, and lymph node dissection. The management of RL is challenging due to its size and proximity to vital organs. Complete surgical resection is crucial for recurrence-free survival. Preoperative radiotherapy can aid in achieving negative margins by defining target volumes and reducing irradiation of adjacent tissues. Chemotherapy is reserved for high-grade tumors with metastatic potential. This report highlights the complexities of managing giant RL, underscoring the importance of thorough surgical planning, multidisciplinary collaboration, and assessing potential adjunct therapies to improve patient prognosis.

A Successfully Treated Case of Invasive Ocular Surface Squamous Neoplasia Involving the Subtotal Cornea in a Monocular Patient: Management in a Resource-Constrained Setting

Abstract: We present a case of a 65-year-old monocular patient who was clinically diagnosed with ocular surface squamous neoplasia covering all but 2 clock hours of the limbus and almost the entire cornea. He underwent complete tumor excision followed by amniotic membrane transplantation. Postexcision, the patient had a clear cornea and stable ocular surface without inflammation or recurrence for 18 months of follow-up. The visual acuity improved to 6/18 from count fingers at face. The histopathology result uncovered squamous cell carcinoma of conjunctiva and cornea. The absence of recurrence can be attributed to complete excision and intraoperative mitomycin C.

Case Report: Surgical management of petrous face meningioma

Petrous face meningioma presents a significant difficulty in neurosurgery because of its complex anatomical position near cranial nerves, brainstem, and important blood vessels. This case report describes the clinical course and successful surgical treatment of a 50-year-old female patient who had a two-month history of ataxia, along with a one-week episode of severe headache and vomiting. An MRI verified the existence of a petrous face meningioma after a thorough diagnostic assessment. Following that, the patient had a left retro-sigmoid craniotomy, which led to the complete excision of the tumour and relief of symptoms. A thorough one-month follow-up examination showed no recurring symptoms, suggesting a positive result and successful clearance of the meningioma. This case highlights the need of timely diagnosis and surgical treatment in dealing with petrous face meningioma, focusing on attaining complete tumour excision. This case demonstrates the success of complete removal of a tumour and the possibility of full return of neurological function in individuals with similar symptoms. This article enhances the current literature by offering insights into the management of petrous face meningioma and recommending a thorough surgical strategy to improve patient outcomes.

GASTRIC GASTROINTESTINAL STROMAL TUMOR WITH SUCCINATE DEHYDROGENASE B DEFICIENCY: CLINICAL CASE

Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors found in the gastrointestinal tract, constituting a diverse group of c-Kit positive mesenchymal (stromal or connective tissue) tumors. Their development is primarily associated with mutations in the c-Kit proto-oncogene, leading to structural alterations in the type III transmembrane tyrosine kinase receptor (Kit). This receptor is crucial for regulating mitotic activity and cell differentiation. The activation of the Kit-receptor in tumor cells is identified through the expression of the immunohistochemical marker CD 117 (tyrosine kinase receptor protein), with approximately 80-90% of GISTs testing positive for CD 117. The objective of our study is to improve the diagnosis and treatment of gastrointestinal stromal tumors. The clinical case underscores the challenge of diagnosing gastrointestinal stromal tumors (GISTs) due to the absence of specific and definitive symptoms. In this instance, only radical surgical intervention facilitated an accurate diagnosis. Given the location of the tumor in the pyloric part of the gastric submucosal layer, a reliable biopsy during video esophagogastroduodenoscopy was unfeasible, as the gastric mucosa above the tumor appeared unaffected. Consequently, surgery with complete tumor excision and subsequent pathohistological and immunohistochemical analysis emerged as the primary diagnostic and therapeutic approach. These investigations confirmed the presence of a gastrointestinal stromal tumor of the stomach with succinate dehydrogenase B deficiency. In approximately 80% of GIST cases, succinate dehydrogenase deficiency plays a pivotal role. The absence of succinate dehydrogenase disrupts the Krebs cycle, leading to an accumulation of succinate, an oncometabolite that fuels carcinogenesis. Such tumors exhibit distinctive clinical characteristics, prognostic outcomes, and responsiveness to targeted therapies. Succinate dehydrogenase deficiency can arise from mutations or epigenomic alterations affecting gene expression. Notably, mutations or epigenomic disruptions in any succinate dehydrogenase subunit inevitably result in the loss of subunit B expression.

Soft Palate Pleomorphic Adenoma of a Minor Salivary Gland: An Unusual Presentation

Tumors of salivary glands are less frequent in the head and neck region. Pleomorphic adenoma (PA) is a benign tumor of major and accessory salivary glands. The soft palate is one of the most frequent sites among accessory salivary glands. This tumor can increase in size and cause oropharyngeal obstruction with a risk of asphyxia, endangering the patient's life. Treatment is based on complete tumor excision and it’s sometimes difficult. Histopathological examination confirms the diagnosis. In this study, we present a case of a large pleomorphic adenoma of the accessory salivary glands located in the soft palate, successfully treated with intraoral excision surgery after an initial tracheostomy.

BiZact-Assisted Endoscopic Resection of a Sinonasal Tumor.

The BiZact device, a bipolar electrosurgical scissor designed for tonsillectomy, minimizes thermal tissue damage and seals blood vessels <3 mm in diameter while dividing the soft tissue. This study describes the authors' experience with sinonasal tumor surgery using a BiZact and discusses its clinical utility and advantages. The authors analyzed BiZact-assisted endoscopic sinonasal tumor surgery cases between January 2021 and May 2023. Data were collected on patients' demographics, histopathology, extent of tumor involvement, surgical records, and postoperative medical records. Clinical utility was assessed using the success rate of complete tumor excision, estimated blood loss during surgery, device-related complications, and operation time. A survey of the surgeons' BiZact experience was also conducted. The diagnoses of the 20 patients in this study included squamous cell carcinoma (n = 2), malignant melanoma (n = 1), sarcoma (n = 1), natural killer cell lymphoma (n = 1), inverted papilloma (n = 12), angiofibroma (n = 2), and schwannoma (n = 1). This pilot study demonstrated a shortened operative time, with a median of 0.8 hours and <100 mL of intraoperative blood loss. In addition, no BiZact-related complications were observed. The BiZact device allows efficient sinonasal surgery because it has the unique advantage of one-step sealing and cutting. BiZact-assisted endoscopic sinonasal tumor surgery is a beneficial and safe procedure that reduces blood loss during surgery, shortens the operative time, and minimizes postoperative complications.

Surgical Outcome of Vestibular Schwannoma in a Tertiary Care Hospital, Dhaka

Background: Presenting symptoms, treatment considerations, and outcome are strongly related to the extension of vestibular schwannomas (VS). The aim of the current retrospective study was to analyze the clinical features, microsurgical treatment, and outcome of VS with brainstem compression. Methods: 130 patients presented with VS who had undergone operative procedures performed in our unit from Jan, 2017 to may, 2022. The facial nerve function and hearing assessment was done according to House-Brackmann [HB] grading and pure tone audiometry (PTA) respectively. All patients were operated by retro-sigmoid retromastoid sub-occipital approach. Results: Most patients had large tumors and had no useful hearing (75.38%), had disabling cerebellar ataxia (84.61%) and presented with features of raised intracranial pressure (46.15%). Complete tumor excision was carried out 92.30% and anatomical preservation of facial nerve was achieved in 87.50% cases. Hearing preservation was achieved in eight patients. Cerebrospinal fluid leak with or without meningitis and transient lower cranial nerve paresis were common complications. The mortality rate was 7.69% Conclusions: Complete tumor excision with good facial nerve preservation can be achieved in large vestibular schwannomas. Hearing preservation is difficult in larger tumors. Primary microsurgical resection is an appropriate management option for large VS. In our experience, this goal can be achieved safely and successfully by using the retromastoid retrosigmoid sub-occipital approach. Bang. J Neurosurgery 2023; 12(2): 86-93

Long-term follow-up of non-myasthenic patients with early-stage thymoma who underwent extended thymectomy or limited resection

BackgroudThe standard resection for early-stage thymoma is total thymectomy and complete tumour excision with or without myasthenia gravis but the optimal surgery mode for patients with early-stage non-myasthenic thymoma is debatable. This study analysed the oncological outcomes for non-myasthenic patients with early-stage thymoma treated by thymectomy or limited resection in the long term. MethodsPatients who had resections of thymic neoplasms at Taipei Veteran General Hospital, Taiwan between December 1997 and March 2013 were recruited, exclusive of those combined clinical evidence of myasthenia gravis were reviewed. A total of 113 patients were retrospectively reviewed with pathologic early stage (Masaoka stage I and II) thymoma who underwent limited resection or extended thymectomy to compare their long-term oncologic and surgical outcomes. ResultsThe median observation time was 134.1 months [interquartile range (IQR) 90.7–176.1 months]. In our cohort, 52 patients underwent extended thymectomy and 61 patients underwent limited resection. Shorter duration of surgery (p < 0.001) and length of stay (p = 0.006) were demonstrated in limited resection group. Six patients experienced thymoma recurrence, two of which had combined myasthenia gravis development after recurrence. There was no significant difference (p = 0.851) in freedom-from-recurrence, with similar 10-year freedom-from-recurrence rates between the limited resection group (96.2 %) and the thymectomy group (93.2 %). Tumour-related survival was also not significantly different between groups (p = 0.726).result ConclusionPatients with early-stage non-myasthenic thymoma who underwent limited resection without complete excision of the thymus achieved similar oncologic outcomes during the long-term follow-up and better peri-operative results compared to those who underwent thymectomy.

Transurethral Resection of Bladder Tumor – Elements of the Surgical Technique

Summary Transurethral resection of bladder tumor (TURBT) is one of the common uro-oncological interventions for diagnosing, staging, and treating bladder cancer, particularly in non–muscle-invasive and select muscle-invasive cases. As a minimally invasive, repeatable procedure performed through natural orifices, TURBT aims to achieve complete tumor excision and provide sufficient tissue for histopathological evaluation, including tumor type, grade, and stage. However, considerable variability in the technical proficiency of urologists affects the quality of resection and clinical outcomes. Evidence suggests optimal results are typically attained after 100 to 170 TURBT procedures, particularly in complex cases. To enhance surgical quality and reduce the likelihood of early recurrence, particularly in non–muscle-invasive bladder cancer, the adoption of standardized protocols and surgical checklists is recommended. Despite its deceptively simple appearance, TURBT remains the cornerstone of bladder cancer management, with continuous refinement in surgical technique and adherence to best practices critical for achieving favorable oncological outcomes.

Implantable, 3D-Printed Alginate Scaffolds with Bismuth Sulfide Nanoparticles for the Treatment of Local Breast Cancer via Enhanced Radiotherapy.

Surgical removal of tumor tissue remains the primary clinical approach for addressing breast cancer; however, complete tumor excision is challenging, and the remaining tumor cells can lead to tumor recurrence and metastasis over time, which substantially deteriorates the life quality of the patients. With the aim to improve local cancer radiotherapy, this work reports the fabrication of alginate (Alg) scaffolds containing bovine serum albumin (BSA)-coated bismuth sulfide (Bi2S3@BSA) nanoradiosensitizers using three-dimensional (3D) printing. Under single-dose X-ray irradiation in vitro, Alg-Bi2S3@BSA scaffolds significantly increase the formation of reactive oxygen species, enhance the inhibition of breast cancer cells, and suppress their colony formation capacity. In addition, scaffolds implanted under tumor tissue in murine model show high therapeutic efficacy by reducing the tumor volume growth rate under single-dose X-ray irradiation, while histological observation of main organs reveals no cytotoxicity or side effects. 3D-printed Alg-Bi2S3@BSA scaffolds produced with biocompatible and biodegradable materials may potentially lower the recurrence and metastasis rates in breast cancer patients by inhibiting residual tumor cells following postsurgery as well as exhibit anticancer properties in other solid tumors.

Sinonasal adenocarcinoma presented as a giant anterior cranial fossa mass: a case report and review of the literature

BackgroundIntestinal adenocarcinoma accounts for less than 0.1–4% of all malignancies in the region. It is common among woodworkers and leather workers. Sinonasal adenocarcinoma usually arises from the ethmoid sinus (40%) or nasal cavity (25%). Extension to nearby structures is common, but intracranial spread is very rare. These tumors are usually treated with surgery, with a reported 5-year survival rate of 59% to 80%.Case presentationThis is a 60-year-old Black African male patient who presented with globalized headache, nasal obstruction with snoring during sleep, anosmia, change in mentation, sometimes agitation and left-side visual loss of one-year duration with worsening his above symptoms over the last one month. He couldn’t smell soap bilaterally; in his left eye he could see only hand movement at nearly 30 cm. On brain magnetic resonance imaging, there was a T1 hypo- and T2 hyper-intense anterior cranial fossa mass arising from the left ethmoid sinuses and sphenoid sinuses and compressing the left optic structures, and brain computed tomography demonstrated heterogeneous hypo- to isodense mass. Complete tumor excision achieved and discharged with significant improvement and linked to oncology unit for radiotherapy.ConclusionThe management of these patients is multidisciplinary, involving neurosurgeons, otolaryngologists, oncologists, and maxillofacial surgeons. Surgical resection is the main treatment strategy, followed by radiotherapy, particularly intensity-modulated therapy. Chemotherapy is used in highly advanced, metastatic, and unresectable tumors.

Updates on management of gliomas in the molecular age.

Gliomas are primary brain tumors derived from glial cells of the central nervous system, afflicting both adults and children with distinct characteristics and therapeutic challenges. Recent developments have ushered in novel clinical and molecular prognostic factors, reshaping treatment paradigms based on classification and grading, determined by histological attributes and cellular lineage. This review article delves into the diverse treatment modalities tailored to the specific grades and molecular classifications of gliomas that are currently being discussed and used clinically in the year 2023. For adults, the therapeutic triad typically consists of surgical resection, chemotherapy, and radiotherapy. In contrast, pediatric gliomas, due to their diversity, require a more tailored approach. Although complete tumor excision can be curative based on the location and grade of the glioma, certain non-resectable cases demand a chemotherapy approach usually involving, vincristine and carboplatin. Additionally, if surgery or chemotherapy strategies are unsuccessful, Vinblastine can be used. Despite recent advancements in treatment methodologies, there remains a need of exploration in the literature, particularly concerning the efficacy of treatment regimens for isocitrate dehydrogenase type mutant astrocytomas and fine-tuned therapeutic approaches tailored for pediatric cohorts. This review article explores into the therapeutic modalities employed for both adult and pediatric gliomas in the context of their molecular classification.

Intraoperative Flow Cytometry for the Rapid Diagnosis and Validation of Surgical Clearance of Non-Melanoma Skin Cancer: A Prospective Clinical Feasibility Study.

Non-melanoma skin cancer (NMSC) is the most prevalent cancer in humans, with a high global incidence. We present a prospective clinical feasibility study on the use of intraoperative flow cytometry (iFC) for the instant diagnosis of NMSC and its complete surgical clearance. Flow cytometry, a laser-based technique, quantifies cell features, which has applications in cancer research. This study aim is to explore the potential applicability of iFC in detecting and characterizing NMSC and its surgical margins. In total, 30 patients who underwent diagnosis for NMSC were recruited. The method demonstrated high sensitivity (95.2%) and specificity (87.1%), with an accuracy of 91.1%, as confirmed with a receiver operating characteristic curve analysis. The results also indicated that most tumors were diploid, with two cases being hypoploid. The average G0/G1 fractions for normal and tumor tissue samples were 96.03 ± 0.30% and 88.03 ± 1.29%, respectively, with the tumor index escalating from 3.89 ± 0.30% to 11.95 ± 1.29% in cancerous cells. These findings underscore iFC's capability for precise intraoperative NMSC characterization and margin evaluation, promising enhanced complete tumor excision rates. Given the technique's successful application in various other malignancies, its implementation in NMSC diagnosis and treatment holds significant promise and warrants further research in clinical trials.

Reoccurrence of Pyogenic granuloma in a pregnant patient - A case report

Pyogenic granuloma (PG) is a common benign vascular neoplasm that grows rapidly on the skin and mucosal tissues, often leading to surface ulceration and tissue damage. Pregnant women are more prone to developing PG, with up to 5% of pregnant women experiencing the condition. To the best of our knowledge, no case study has been published to date illustrating the management of PG in pregnant patients vulnerable to hemorrhage. A 27-year-old pregnant woman receiving anticoagulant therapy presented with painful lumps on the tongue. She had previously undergone surgical removal of a lump, which reappeared after a month. An external oral examination revealed swelling and a raised, reddish, oval-shaped lesion behind the lower anterior teeth. The lesion was pedunculated with a smooth surface and bleeding. Owing to recurrence and pain, the lumps were excised again using a scalpel. The excised tissue specimens were sent for histopathological assessment to confirm the diagnosis of PG. The tumor was removed with minimal trauma and pressure was applied sublingually to minimize bleeding. Tissue glue was applied for hemostasis, and the patient was instructed to prevent bleeding by applying pressure to the excised area. At the one-week follow-up, no complications were observed. This case report highlights the therapeutic significance of complete tumor excision and pressure therapy in mitigating excessive bleeding, particularly in patients receiving anticoagulant therapy.

Laryngeal Sarcoma: A Case Report

Laryngeal sarcoma is a rare malignant tumour and the diagnosis requires comprehensive histopathological and immunohistochemical examinations. Due to its rarity, there is paucity of information on its behaviour and management. We report a case of an elderly male presented with one month history of hoarseness. Laryngoscopic examination showed a large exophytic mass at anterior commissure causing partial airway obstruction. Tracheostomy, direct laryngoscopy and excision of tumour with adequate margin were performed. The histopathological examination revealed myofibroblastic sarcoma. Computed tomography of the neck showed no regional or distant metastasis. Post-operatively, he was decannulated and there was no clinical evidence of recurrence. Management of LS is highly individualised. Complete tumour excision with clear margins is the primary treatment. Neck dissection is not required if there is no nodal metastasis. Radiotherapy is advocated in selected cases to achieve loco-regional control.

Squamous cell carcinoma arising in the background of an epidermoid cyst: A case report from Syria

Introduction: Malignant transformation of epidermoid cysts is rare, it accounts for 1% of all diagnosed cysts. Transformation into squamous cell carcinoma and basal cell carcinoma can occur. Clinical examination, radiological examination, and pathological confirmation are necessary for diagnosis and the treatment of choice is usually surgical excision. Case Report: A 57-year-old Syrian female patient presented to our hospital with a huge mass on the back. Computed tomography revealed a subcutaneous huge mass 25.0 × 20.0 × 9.0 cm extended from cervical vertebrae level into upper lumbar vertebrae. Surgery with the intent of wide and complete excision was performed but it was difficult to obtain complete excision of tumor because of extension into the deep muscles. The diagnosis was made by histopathologic examination. It was a malignant transformation into squamous cell carcinoma arising from the epidermoid cyst. The patient received radiotherapy after surgery because of incomplete excision of tumor. Conclusion: This case shows an unusual presentation of a huge epidermoid cyst on the back with transformation into malignancy. We aimed to highlight the importance of early diagnosis and treatment of these cysts.

Open versus Endoscopic and Microscopic Pituitary Adenoma Excision– An Institutional Experience

Introduction: For symptomatic nonsecreting pituitary adenomas (PAs), surgical resection remains the treatment of choice. In this retrospective study, we compare the efficacy of open versus endoscopic and microscopic excision of pituitary adenoma, and to evaluate the merits and demerits of each approach. Material and Methods: This study is a retrospective analysis of patients who underwent surgical excision for symptomatic pituitary adenoma in institute of neurosurgery, madras medical college from January 2022 to December 2022. Various parameters were analyzed including the age, sex, type of surgical resection done, duration of surgery, average blood loss, extent of resection of tumors, and intra- and post-operative complication. Results: A total of thirty eight patients with pituitary adenoma were operated from January 2022 to December 2022. Six patients were operated by endonasal endoscopic transsphenoidal surgery and six patients were operated by microscopic transsphenoidal surgery, 26 patients were operated by Pterional craniotomy and excision of tumour. In an endoscopic and microscopic group, complete tumor excision was achieved in 8 patients (66.6%) and in open surgery group, it was achieved in 6 (23.1%) patients. In endoscopic and microscopic group, the mean operative time was 120 ± 25 min (ranged 80–135 min) and in open surgery group, it was 150 ± 15 min (ranged 130–175 min). In endoscopic and microscopic group, mean blood loss was 120 ± 30 ml (80–160 ml), and in open surgery group, it was 200 ± 15 (150–230 ml). Postoperative CSF leak from wound site was present in 1 case in open surgery group. There was no mortality in either group. Duration of hospital stay was 5 days in endoscopic and microscopic group and 14 days for open surgery group. Conclusion: Endoscopic and microscopic approach provides a wide surgical field and broad lateral vision making easier distinction of tumor tissues. Thus, there is less blood loss, less operative time, less postoperative complication, and early discharge from the hospital.

SURG-39. EVALUATING THE EFFECTIVENESS OF NON-NAVIGATED 2D INTRAOPERATIVE ULTRASOUND IN GLIOMA SURGERY: RECONSIDERING THE PUSH FOR MORE COMPLEX INTRAOPERATIVE IMAGING

Abstract INTRODUCTION In the swiftly evolving domain of neurosurgical technology, conventional methodologies like the non-navigated two-dimensional intraoperative ultrasound (nn-2D-IOUS) might be at risk of being overlooked. This research investigates the clinical effectiveness and surgical significance of nn-2D-IOUS, particularly for glioma removal procedures. METHODS This retrospective research, conducted at a single healthcare institution, reviewed 99 unselected patients diagnosed with both high and low-grade gliomas. The main objective was to examine the competency of nn-2D-IOUS in delivering satisfactory image quality, recognizing leftover tumor tissue, and its impact on the extent of tumor removal. Early postoperative MRI data were used as a reliable comparison measure to verify these findings. RESULTS nn-2D-IOUS exhibited notable efficiency, generating superior image quality in nearly 79% of analyzed cases. It showcased a sensitivity of 68% and a remarkable specificity of 100%, thus affirming its instrumental role in intraoperative tumor identification. In scenarios where complete tumor excision was intended, a resection surpassing 95% of the original tumor volume was accomplished in 86% of patients. Moreover, when the nn-2D-IOUS didn't detect residual tumor, the average volume of overlooked tumor tissue was significantly small, approximately 0.27 cm³. CONCLUSION Our research presents persuasive evidence emphasizing the critical role and effectiveness of nn-2D-IOUS in glioma surgeries. The findings underline the potential of leveraging cost-efficient, traditional technologies like nn-2D-IOUS to attain superior surgical results, even when compared to more sophisticated alternatives. This understanding has profound implications, especially for resource-limited environments, underscoring the need to maximize the usage of available tools to enhance patient care in a practical, economical manner.