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5-ALA fluorescence guides resection of recurrent glioblastoma multiforme
Date:2/19/2013

Charlottesville, VA, February 19, 2013. Neurosurgeons from UC San Francisco describe the use of 5-aminolevulinic acid (5-ALA) fluorescence in guiding resection of recurrent glioblastoma multiforme (GBM). Ingestion of 5-ALA by a patient before surgery leads to fluorescence of tumor cells intraoperatively in response to certain wavelengths of light. This can provide information not necessarily available through magnetic resonance imaging (MRI), the standard mode of imaging used to detect primary and recurrent GBMs. The additional information provided by 5-ALA fluorescence can guide surgeons in the treatment of individual cases.

The case of a 56-year-old man is described in the article "Subependymal spread of recurrent glioblastoma detected with the intraoperative use of 5-aminolevulinic acid. Case report," by Tene A. Cage, M.D., Melike Pekmezci, M.D., Michael Prados, M.D., and Mitchel S. Berger, M.D., published today online, ahead of print, in the Journal of Neurosurgery. The patient presented with frequent transient visual disturbances. Seven years earlier, he had undergone gross-total (maximum) resection of a GBM located in the right occipital lobe. A new MRI study was performed and the images showed three distinct, new sites of tumor in the man's right temporal lobe. There was no evidence of recurrent tumor at the site where the original tumor had been located.

Glioblastoma multiforme (GBM) is the most common primary tumor of the brain. It is extremely aggressive and is usually treated with resection followed by chemotherapy and radiotherapy. Even using this treatment, patient survival is not long: on average 1 to 2 years. The authors note that the best way to lengthen survival is to remove as much tumor as possible. This holds for recurrent GBM as well as for the initial tumor.

The patient in this case was scheduled for surgery to remove the
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Contact: Jo Ann M Eliason
jaeliason@thejns.org
434-982-1209
Journal of Neurosurgery Publishing Group
Source:Eurekalert

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