Brain Tumor Res Treat.  2013 Apr;1(1):45-49. 10.14791/btrt.2013.1.1.45.

5-Aminolevulinic Acid Fluorescence Discriminates the Histological Grade of Extraventricular Neurocytoma

• Song SW
• Kim YH
• Park SH
• Park CK

• KMID: 2165223
• DOI: http://doi.org/10.14791/btrt.2013.1.1.45

Abstract

Extraventricular neurocytomas are rare brain tumors that have a diverse range of clinical characteristics. We describe two cases involving fluorescence-guided resection of extraventricular neurocytoma using 5-aminolevulinic acid (5-ALA) and evaluate the efficacy of the technique. We found that the tumor reactions to 5-ALA differed depending on the histologic grade. This finding shows that the 5-ALA fluorescence reaction may potentially be used as a biomarker of the clinical behavior of these tumors. To our knowledge, this is the first report in which fluorescence-guided resection was utilized for the resection of extraventricular neurocytomas.

Keyword

Extraventricular neurocytoma; Fluorescence guided surgery; 5-aminolevulinic acid

MeSH Terms

Brain Neoplasms
Fluorescence*
Neurocytoma*

Figure

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  Fig. 1 A: A transaxial T2-weighted MR image showing a diffuse high signal mass in the left temporal lobe. B: The mass was not enhanced in the coronal T1-weighted MR image with contrast. C and D: No fluorescence reaction was observed in any tumor tissue during surgery. E: The tumor composed of uniform round cells with or without clear cytoplasm (hematoxylin-eosin staining). F: Immunohistochemical staining for synaptophysin showing diffuse, strong reactivity in the tumor cells. MR: magnetic resonance.

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  Fig. 2 A and B: A preoperative MRI scan showing a right high frontal mass with high signal intensity on a T2-weighted image and focal enhancement on a T1-weighted image with contrast. C and D: Intraoperatively, the mass showed positive fluorescence reaction and was red after illumination with ultrawave light of 440-nm wavelength. E: The tumor was composed of monotonous round cells with clear cytoplasm (hematoxylin-eosin staining). F: Immunohistochemical staining for synaptophysin showing diffuse, strong reactivity in the tumor cells. MRI: magnetic resonance imaging.

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