Turkish Neurosurgery 2015 , Vol 25 , Num 5
5-Aminolevulinic Acid-Induced Fluorescence in Cerebellar Primary Central Nervous System Lymphoma: A Case Report and Literature Review
Junkoh YAMAMOTO, Takehiro KITAGAWA, Daisuke AKIBA, Shigeru NISHIZAWA
University of Occupational and Environmental Health, Department of Neurosurgery, Kitakyushu, Japan DOI : 10.5137/1019-5149.JTN.10594-14.1 5-Aminolevulinic acid (5-ALA)-induced fluorescence-guided resection is a widely used procedure for patients with malignant gliomas. However, the clinical application of 5-ALA for surgery in primary central nervous system lymphoma (PCNSL) is uncommon. Here, we present a case of PCNSL treated using 5-ALA-induced fluorescence-guided resective surgery. A 70-year-old woman presented with cerebellar ataxia, and magnetic resonance imaging revealed an irregularly shaped and homogenously enhanced mass with surrounding brain edema in the vermis that extended to the right hemisphere of the cerebellum. Under the preoperative diagnosis of a malignant glioma in the cerebellum, the patient underwent 5-ALA-induced fluorescence-guided surgery. Under blue light illumination, the tumor revealed strong 5-ALA-induced fluorescence. The tumor was identified as a diffuse large B-cell lymphoma. After partial resection, the patient received adjuvant chemotherapy and radiotherapy. Importantly, the neurological deficit of the patient improved, and recurrence of the tumor was not observed 21 months post-surgery. Together with previous reports, this case study emphasizes the efficacy of the surgical application of 5-ALA for PCNSL. Keywords : Glioma, Subventricular zone, Ependyma, Surgery, Diffuse large B-cell lymphoma, Dissemination, 5-ALA
Corresponding author : Junkoh Yamamoto, yama9218@med.uoeh-u.ac.jp