An Australian expatriate living in Ho Chi Minh City experienced unexplained chest pain, hallucinations, and seizures, symptoms initially thought to be signs of heart disease. A brain MRI later revealed a rare vascular tumour located deep within his brain. Thanks to a timely surgical decision at FV Hospital, he made a remarkable recovery and returned to normal life after just four days.

Heart Disease Suspected, but a Rare Brain Tumour Was the Cause

Recently, Mr. S.F., a 63-year-old Australian living in Ho Chi Minh City, had been experiencing frequent, severe chest pain. Initially, he sought treatment at a major private hospital, where all cardiac test results came back entirely normal. However, a follow-up brain MRI revealed a small tumour, leading doctors to suspect that his chest pain could actually be a manifestation of epilepsy.

He was prescribed anti-epileptic medication and advised to limit many daily activities, no swimming, no climbing, and especially no driving for at least six months. Feeling that this approach only addressed his symptoms rather than the root cause, the tumour in his brain, Mr F. decided to come to FV Hospital for a more thorough assessment and treatment.

After reviewing his examination and test results, Dr Tran Luong Anh, Specialist Level II and Head of the Neurosurgery and Spine Surgery Department, diagnosed that the patient was suffering from a rare cavernous malformation located in the hippocampus of the temporal lobe – an area responsible for short-term memory.

“This is a congenital vascular malformation, which usually only presents symptoms when bleeding occurs or when it grows larger. Because it is located in such a critical area of the brain, once bleeding happens, the tumour will trigger epileptic seizures,” explained Dr Luong Anh.

This tumour was the cause of visceral epilepsy, a form of seizure disorder that produces internal convulsions, often in the chest. At the same time, he experienced a range of cognitive disturbances, including severe auditory hallucinations, hearing strange sounds, and even visual hallucinations, such as seeing things that are not there. At its peak, on 17 and 18 June, Mr F. endured five consecutive seizures, accompanied by dizziness and increasingly severe hallucinations.

“If the true cause, a bleeding tumour, is not identified and treated promptly, the patient could be misdiagnosed with a psychiatric disorder, leading to the wrong and potentially life-threatening treatment approach,” emphasised Dr Luong Anh.

Locating and Removing a Dangerous, Pea-Sized Brain Tumour

Concerned that the lesion could bleed more severely and lead to unpredictable complications, Mr F. agreed to undergo urgent surgery. Dr Tran Luong Anh, Head of Neurosurgery and Spine Surgery Department at FV Hospital, promptly conducted a detailed review of the case and developed a precise surgical plan.

Although the tumour measured just 9 × 14 mm, it was “hidden” approximately 5 cm deep within the cerebral cortex, a highly sensitive location. Even the slightest deviation in surgical technique could have caused significant damage to surrounding tissue. The greatest challenge of the operation was to find the exact “coordinates” of the lesion and remove it without harming the healthy brain tissue critical to the patient’s memory.

Dr Luong Anh used a mini-open approach, a very small craniotomy designed to minimise collateral damage. Assisted by a modern navigation system, functioning like a surgical GPS, he was able to guide a small surgical sheath directly to the tumour and approach it with millimetre-level accuracy.

The challenges did not end there. During surgery, the brain can “shift” due to changes in intracranial pressure and cerebrospinal fluid flow, making pre-operative MRI navigation data less accurate. At this critical stage, the surgeon’s expertise and skill were crucial, as even the slightest deviation could result in severe complications.

The navigation system proved to be an invaluable tool, ensuring absolute precision throughout the procedure. After nearly two hours of meticulous surgery, the tumour was successfully removed. The result was remarkable: the seizures, hallucinations, and visceral spasms disappeared entirely. Just four days later, Mr F. was discharged in good health and returned to normal life.

“The doctors are excellent! I am fortunate to have chosen FV.”

Having undergone several surgeries in his life, including wisdom tooth extraction, three knee operations, and an appendectomy, this was the first time Mr F. had faced brain surgery, and he admitted to being deeply frightened.

“When I came to FV, I was very anxious. But the way the doctors spoke to me, clearly explaining every risk and each step of the treatment, made me feel reassured. I had thought about postponing the surgery, even considered returning to Australia for treatment, but after hearing the doctor explain the serious risks if the seizures recurred, I decided to go ahead with the surgery immediately,” Mr F. recalled.

The moment he awoke after surgery, Mr F. felt overwhelmed with happiness, the seizures and hallucinations that had haunted him for so long had almost completely disappeared. “I think I was lucky to choose FV. Everything here is wonderful. The doctors are highly skilled, the staff are dedicated, and everyone cared for me like family. I am truly happy,” he shared during his follow-up in early August.

Dr Tran Luong Anh is recognised as one of the leading experts in brain and spine surgery. He consistently prioritises minimally invasive techniques to reduce pain, accelerate recovery, and preserve maximum brain function for patients. Complementing this, FV’s advanced medical equipment serves as a vital ally, enabling surgeons to achieve exceptional precision in even the most complex cases and deliver the best possible outcomes for patients.

For consultations with Dr Tran Luong Anh, Specialist Level II, regarding brain and spinal conditions, please contact Neurosurgery and Spine Surgery Department at FV Hospital via hotline: (028) 35 11 33 33.