Alexander C Fort, Mark Jessup, Miguel Cobas
The Warburg effect describes the phenomenon in which cancer cells preferentially use glycolysis even under aerobic conditions, leading to excessive lactate production. Though more frequently described in hematologic malignancies, this mechanism can also be seen in solid tumors. Here we report a case of an 84-year-old man who developed a profound intraoperative lactic acidosis during glioblastoma resection, likely attributable to the Warburg effect. This case highlights the importance of maintaining broad differential diagnoses of lactic acidosis. Anesthesiologists, surgeons, and intensivists should be aware of this phenomenon, as failure to recognize the diagnosis may result in unnecessary and potentially harmful interventions.