5-ALA fluorescence-guided endoscopic surgery for mixed germ cell tumors

Journal of Neuro-oncology
Junichi TakedaAkio Asai

Abstract

5-Aminolevulinic acid (5-ALA) fluorescence-guided surgery is widely used for detection and planning of resection of malignant gliomas and other brain tumors. However, no reports have described 5-ALA fluorescence-guided surgery or direct visualization of germ cell tumors. Here, we report two cases of germ cell tumors in which a positive 5-ALA fluorescent signal was visualized with a neuroendoscope. Both cases had a tumor in the pineal region that was associated with hydrocephalus. The patients underwent surgery after administration of 5-ALA. After ventricular puncture of the anterior horn, we could observe the ventricular wall and tumor using the Karl Storz Photodynamic diagnosis system endoscope. Then, biopsy of the pineal tumor and endoscopic third ventriculostomy were performed in both cases. In case 1, a 22-year-old man, part of the ventricular wall and tumor tissue showed red fluorescence. In case 2, a 16-year-old man, part of the fornix and infundibular recess showed red fluorescence, and the tumor showed relatively weak red fluorescence. The histopathological diagnosis of both cases was pure germinoma. This is the first report of direct visualization of mixed germinomas with 5-ALA fluorescence-guided endoscopic surgery. T...Continue Reading

References

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Citations

Jan 5, 2019·Journal of Neuro-oncology·Ricardo Díez ValleWalter Stummer
Nov 7, 2019·Brain Tumor Research and Treatment·So Young JiChul Kee Park
Sep 26, 2019·Frontiers in Oncology·Sergey A GoryaynovAlexandr A Potapov
Jul 6, 2021·Frontiers in Neurology·Alexander J SchupperConstantinos G Hadjipanayis

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