Fluorescence-guided resections have become standard of care for malignant gliomas.Strong fluorescence has been shown to correlate with solid enhancing tumor.However, with experience it KNIT TOPSSLVLESSCAMI/TANK has also been shown that visualized fluorescence may not identify the entire extent of the tumor.Knowing that malignant gliomas extend beyond the contrast-enhancing tumor seen on magnetic resonance imaging (MRI), reliance only on the fluorescence intraoperatively may not be enough.Intraoperative ultrasound is a readily available tool for real-time assessment of resection status, irrespective of the tumor type.
We describe one such case in which after resecting all the visible fluorescing tumor component, we identified a significant component of nonfluorescing tumor, using intraoperative ultrasound that was further resected completely.This illustrates the Multi-Tools need for multimodal intraoperative guidance for achieving optimal tumor resection in malignant gliomas.