5-Aminolevulinic acid fluorescence-guided surgery for spinal cord melanoma metastasis: a technical note

Acta Neurochir (Wien). 2018 Oct;160(10):1905-1908. doi: 10.1007/s00701-018-3645-2. Epub 2018 Aug 9.

Abstract

Background: 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.

Method: We describe a microsurgical resection of a spinal cord melanoma through fluorescence-guided technique using 5-ALA in a 36-year-old man.

Results: Strong 5-ALA tumor enhancement was evidenced, resulting in gross-total resection.

Conclusion: 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.

Keywords: 5-Aminolevulinic acid; Fluorescence-guided technique; Metastasis; Spinal cord melanoma.

MeSH terms

  • Adult
  • Aminolevulinic Acid
  • Brain Neoplasms / surgery*
  • Ependymoma / surgery*
  • Female
  • Fluorescent Dyes
  • Humans
  • Male
  • Melanoma / surgery*
  • Meningeal Neoplasms / surgery*
  • Meningioma / surgery*
  • Spinal Cord Neoplasms / surgery*
  • Surgery, Computer-Assisted / methods*

Substances

  • Fluorescent Dyes
  • Aminolevulinic Acid