Scheichel Florian, Ungersboeck Karl, Kitzwoegerer Melitta, Marhold Franz
Department of Neurosurgery, University Hospital of St. Poelten, Propst-Fuehrer-Straße 4, 3130, St. Pölten, Lower Austria, Austria.
Department of Pathology, University Hospital of St. Poelten, Propst-Fuehrerstrasse 4, St. Poelten, 3100 St. Poelten, Lower Austria, Austria.
Acta Neurochir (Wien). 2017 Jun;159(6):1027-1031. doi: 10.1007/s00701-017-3166-4. Epub 2017 Apr 10.
The exact role of 5-aminolevulinic acid (5-ALA) fluorescence-guided meningioma resection is as yet unclear. Although most of the meningiomas show positive fluorescence, the influence on outcome, fluorescence heterogeneity within the tumour, the correlation between fluorescence and the proliferation rate, as well as different quantitative measurements are a matter of debate. Positive fluorescence in bone infiltrative meningiomas is well described, whereas little data exist about 5-ALA fluorescence within soft tissue infiltration. We add a case of histologically confirmed fluorescent tumour infiltration into soft tissue. A 78-year-old woman underwent resection of an atypical meningioma at the University Hospital of St. Poelten. Preoperative imaging showed tumour infiltration throughout the calvaria. 5-ALA fluorescence of the tumour as well as bone, periost and temporal muscle helped to perform a gross total resection. Histological examination showed an atypical meningioma (WHO Grade II) and gave proof of tumour infiltration of the bone and temporal muscle. With the aid of 5-ALA fluorescence, a gross total resection could be performed.
5-氨基乙酰丙酸（5-ALA）荧光引导下的脑膜瘤切除术的确切作用尚不清楚。尽管大多数脑膜瘤显示出阳性荧光，但它对手术结果的影响、肿瘤内部的荧光异质性、荧光与增殖率之间的相关性以及不同的定量测量方法仍存在争议。骨浸润性脑膜瘤中的阳性荧光已有充分描述，而关于软组织浸润内5-ALA荧光的数据却很少。我们补充了一例经组织学证实的荧光肿瘤浸润至软组织的病例。一名78岁女性在圣珀尔滕大学医院接受了非典型脑膜瘤切除术。术前影像学检查显示肿瘤浸润整个颅骨。肿瘤以及骨骼、骨膜和颞肌的5-ALA荧光有助于实现肿瘤全切。组织学检查显示为非典型脑膜瘤（世界卫生组织二级）并证实肿瘤浸润骨骼和颞肌。借助5-ALA荧光，实现了肿瘤全切。
