A team of neurosurgeons at Gleneagles Hospital Chennai has successfully removed a rare and aggressive brain tumor from a 30-year-old man using a carefully planned two-stage surgical procedure, hospital officials confirmed.
The patient, a resident of Lucknow, was admitted in January 2026 with complaints of persistent headache, vomiting, and double vision. Clinical evaluation followed by MRI imaging revealed a tumor located in the posterior part of the third ventricle, a deep and critical region of the brain.
The mass had also led to obstructive hydrocephalus, a condition in which cerebrospinal fluid accumulates inside the brain, resulting in increased intracranial pressure.
Doctors diagnosed the tumor as a high-grade astrocytoma with piloid features (HGAP), a rare and recently classified brain tumor entity. This subtype was formally recognized in the 2021 classification by the World Health Organization.
HGAP is considered an aggressive tumor and requires detailed histopathological and molecular analysis for accurate diagnosis.
A team of doctors led by Dr. Nigel Symss and Dr. Venkatesan Sanjeevi, both senior consultant neurosurgeons, carried out a two-stage surgical procedure lasting around eight hours and successfully removed the tumor without complications.
Due to the tumor’s deep location and proximity to vital structures such as the brainstem and major blood vessels, the surgical team opted for a staged approach to minimize risk.
In the first stage, doctors performed a ventriculoperitoneal (VP) shunt procedure to drain excess cerebrospinal fluid and relieve intracranial pressure. This intervention stabilized the patient before definitive tumor removal.
As reported in APN News, highlighting the patient’s clinical challenges, Dr. Venkatesan Sanjeevi, Senior Consultant in Neurosurgery at Gleneagles Hospital Chennai, explained that the case involved significant complications.
The location of this tumor made it one of the more challenging cases we encounter in Neurosurgery. Careful staging of the procedures and the use of advanced Neuronavigation and Microsurgical techniques allowed us to remove the tumor safely while preserving critical brain functions. The patient’s smooth recovery and early discharge reflect the effectiveness of this approach.
Dr. Venkatesan Sanjeevi, Senior Consultant, Neurosurgery, Gleneagles Hospital, Chennai
The second stage involved tumor excision using a supracerebellar infratentorial approach, a technique commonly used for accessing lesions in deep midline brain regions.
Surgeons utilized neuronavigation systems, high-resolution operative microscopes, and an ultrasonic aspirator to remove the tumor with precision while preserving surrounding brain structures. The procedure lasted approximately eight hours and resulted in near-total tumor removal.
As reported in APN News, Ms. Niranjani, Chief Operating Officer and Hospital Head, Gleneagles Hospital Chennai, said,
Treating rare tumors in deep and functionally critical brain regions requires the right combination of surgical expertise, advanced technology, and coordinated multidisciplinary care. This case reflects our commitment to precision planning, patient safety, and outcomes that minimize morbidity even in highly complex neurosurgical situations.
Ms. Niranjani, Chief Operating Officer and Hospital Head, Gleneagles Hospital Chennai
Postoperative evaluation confirmed the diagnosis through histopathological and molecular studies. The patient showed complete resolution of initial symptoms and did not develop any new neurological deficits after surgery.
He was discharged in stable condition on the eighth day following the procedure.
According to the treating team, tumors located in critical brain regions present significant surgical challenges due to the risk of affecting essential neurological functions. In such cases, staged procedures and advanced surgical technologies play an important role in improving safety and outcomes.
High-grade astrocytomas arise from astrocytes, which are supportive cells in the central nervous system. The HGAP subtype is newly recognized and requires specialized diagnostic methods, highlighting the importance of multidisciplinary management in such cases.
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