The patient is Mr. N.T.P (57 years old, Khanh Hoa), who has spent more than 10 years of treatment for blurred vision in many places but has not detected the cause of the nervous system.
On November 10, he was transferred to Cho Ray Hospital with severe headaches, pituitary dysfunction and severely reduced vision, only being able to distinguish the shadows of his hands. At the Department of Neurosurgery, MRI results recorded a pituitary tumor measuring up to 56 mm - belonging to the group of giant pituitary tumors, accounting for only about 10% of all pituitary tumors.
The tumor block encroaches on the butterfly tubes, cavity tubes, compressing the visual intersection and two internal internal internal internal internal arteries. This is a very complex disease, with the risk of damage to many important blood vessel and nerve structures. According to world medicine, the rate of tumor removal is only 30-40% in large centers.
Faced with the critical condition, the team decided to undergo endoscopic surgery through the nasal - butterfly tubes, a common technique in the Neurosurgery Department. However, this surgery is special in that the crew uses the 4K - ICG Neuroscreen Surgery System, a technology that Cho Ray has applied since mid-2025 and is the first unit in Vietnam to deploy. The system has many specialized features: compact scanning Tube, diverse viewing angles (0 degrees, 30 degrees...), 4K high-resolution images and ICG fluorescent dye support to clearly display the blood vessels and important structures in the surgical area.
Dr. Tran Thien Khiem - the main surgeon - said that the most important requirement of the surgery is to remove the maximum tumor while still preserving the pituitary stalk, the healthy part of the pituitary gland and the adjacent vascular and nervous system, especially the two internal carotid arteries. "Thanks to ICG fluorescence images that display blood vessels clearly in a 4K environment, surgeons can determine tissue boundaries more accurately, thereby facilitating each operation. As a result, we were able to remove almost the entire tumor, contributing to improving treatment effectiveness," said Dr. Khiem.
After 5 days of surgery, the patient was alert, eating and living on his own, his tuyenal function was stable, and his vision improved significantly. Mr. P. shared: "I have had a headache, vomiting, and blurred vision for many years, but I thought it was cerebral anemia. Recently, the disease has got worse, causing insomnia, numbness in the limbs and sometimes evening when walking. When I was diagnosed with a large tumor in my head and had successful surgery, I was very happy. The medical and nursing staff are all dedicated, I am extremely grateful.
Dr. Tran Huy Hoan Bao - Head of the Department of Neurosurgery - commented that giant seiency tumors and complex squid head tumors are always a big challenge in the field of neurosurgical surgery. Tumors are often closely related to visual intersections, cavities, and internal internal internal arteries, making it more difficult to completely remove tumors but still preserve function. Previously, the ability to observe was limited to many risks. When implementing the 4K - ICG Neuroscopy system, the tissue - healthy tissue boundary, the laiferal and vascular vessels are displayed more sharply, he said.
Since its operation, the 4K ICG system has supported the treatment of more than 30 complex cases such as giant yeoctomic tumors, Korean cabbage tumors, meningococcal tumors in the scalp floor, bone cartilage tumors, etc., helping to increase safety, surgical efficiency and significantly improve recovery results of patients.
According to Dr. Tran Huy Hoan Bao, this technology, combined with MRI 3T and the orientation of deploying physiological electrolytes in surgery, contributes to promoting the personalization trend in the treatment of brain tumors in functional areas - optimizing tumor removal but still ensuring vital function for patients. This is an important step forward, opening up more effective treatment opportunities for complex neurological diseases, he affirmed.
