Neurosurgery Department, Neurological Institute of Curitiba (INC), Curitiba, Paraná, Brazil.
Citolab Pathology Exams, Curitiba, Paraná, Brazil.
Acta Neurochir (Wien). 2018 Oct;160(10):1905-1908. doi: 10.1007/s00701-018-3645-2. Epub 2018 Aug 9.
According to our research, just few studies described 5-Aminolevulinic acid (5-ALA) use for spinal injuries resection. 5-ALA is known to be especially useful in certain spinal tumor entities such as meningiomas, ependymomas, hemangiopericytomas, and metastasis of central nervous system primary tumors. In contrast, 5-ALA has limited value in other histopathological tumoral entities, as neurinomas and carcinoma metastasis.
We describe a microsurgical resection of a spinal cord melanoma through fluorescence-guided technique using 5-ALA in a 36-year-old man.
Strong 5-ALA tumor enhancement was evidenced, resulting in gross-total resection.
To our knowledge, this is the first case of nonglial intramedullary metastasis with 5-ALA positive staining. We believe that this tool, 5-ALA, could aid in the resection, identification, and differentiation of medullary metastasis.
根据我们的研究,只有少数研究描述了 5-氨基酮戊酸(5-ALA)在脊髓损伤切除中的应用。已知 5-ALA 特别适用于某些脊髓肿瘤实体,如脑膜瘤、室管膜瘤、血管外皮细胞瘤和中枢神经系统原发性肿瘤的转移。相比之下,5-ALA 在其他组织病理学肿瘤实体中的价值有限,如神经瘤和癌转移。
我们描述了一名 36 岁男性通过荧光引导技术使用 5-ALA 进行脊髓黑色素瘤的显微切除术。
强烈的 5-ALA 肿瘤增强得到证实,实现了大体全切除。
据我们所知,这是首例 5-ALA 阳性染色的非神经胶质髓内转移病例。我们相信,这种工具 5-ALA 可以帮助切除、识别和区分髓内转移。