Solis Waldo Gerard, Hansen Mitchell
Department of Neurosurgery, John Hunter Hospital, New Lambton, New South Wales, Australia
Department of Neurosurgery, John Hunter Hospital, New Lambton, New South Wales, Australia.
BMJ Case Rep. 2017 Apr 11;2017:bcr-2017-219469. doi: 10.1136/bcr-2017-219469.
A 54-year-old man presented with two episodes of dysarthria and left facial droop. Both episodes resolved by the time of examination. MRI of the brain revealed a right frontotemporal, heterogeneously enhancing mass with surrounding vasogenic oedema, suggestive of a high-grade primary brain neoplasm. The patient was administered preoperative 5-aminolevulinic acid hydrochloride (Gliolan), and fluorescence-guided resection of the lesion was undertaken. infection was diagnosed from the specimen and the patient was given appropriate antifungal treatment. This is the first reported case of Gliolan-mediated fluorescence in a fungal abscess and highlights one of the potential pitfalls in fluorescence-guided surgery.
一名54岁男性出现两次构音障碍和左侧面部下垂。两次发作在检查时均已缓解。脑部MRI显示右侧额颞叶有一个不均匀强化的肿块，周围伴有血管源性水肿，提示为高级别原发性脑肿瘤。患者术前接受了盐酸5-氨基酮戊酸（Gliolan）治疗，并进行了荧光引导下的病变切除术。从标本中诊断出感染，患者接受了适当的抗真菌治疗。这是首例报道的Gliolan介导的真菌性脑脓肿荧光病例，突出了荧光引导手术中一个潜在的陷阱。
