Yuji Agawa1, Takafumi Wataya2. 1. Department of Neurosurgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan. 2. Department of Neurosurgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan. watayatakafumi@gmail.com.
Abstract
PURPOSE: Astroblastoma is an uncommon pediatric neuroepithelial tumor. The prognosis and appropriate treatment of astroblastoma were not well understood. Previous reports suggested the best treatment for astroblastoma is surgical total resection. The authors report a case of pediatric astroblastoma that underwent gross total resection with the use of fluorescent guidance by 5-aminolevulinic acid (5-ALA). CASE REPORT: A 13-year-old girl presented with the tumor that was well-circumscribed cystic and solid mass with marked gadolinium enhancement in the right occipital lobe. At surgery, fluorescence of the tumor was clearly distinctive from the normal cerebral tissue. All fluorescent tissue including residual cyst wall was removed. Postoperative MRI showed gross total resection of the tumor. No serious side effect or complications occurred. The histopathologic diagnosis was suggestive of astroblastoma. The patients had no evidence of recurrence of tumor without adjuvant radiotherapy during the last 1 year of follow-up time. CONCLUSION: 5-ALA is useful to achieve gross total resection including cystic lesion of pediatric astroblastoma. A larger prospective study is warranted to establish the use of 5-ALA in pediatric brain tumor.
PURPOSE:Astroblastoma is an uncommon pediatric neuroepithelial tumor. The prognosis and appropriate treatment of astroblastoma were not well understood. Previous reports suggested the best treatment for astroblastoma is surgical total resection. The authors report a case of pediatric astroblastoma that underwent gross total resection with the use of fluorescent guidance by 5-aminolevulinic acid (5-ALA). CASE REPORT: A 13-year-old girl presented with the tumor that was well-circumscribed cystic and solid mass with marked gadolinium enhancement in the right occipital lobe. At surgery, fluorescence of the tumor was clearly distinctive from the normal cerebral tissue. All fluorescent tissue including residual cyst wall was removed. Postoperative MRI showed gross total resection of the tumor. No serious side effect or complications occurred. The histopathologic diagnosis was suggestive of astroblastoma. The patients had no evidence of recurrence of tumor without adjuvant radiotherapy during the last 1 year of follow-up time. CONCLUSION:5-ALA is useful to achieve gross total resection including cystic lesion of pediatric astroblastoma. A larger prospective study is warranted to establish the use of 5-ALA in pediatric brain tumor.
Entities:
Keywords:
5-aminolevulinic acid; Astroblastoma; Gross total resection; Pediatric
Authors: Victor Hugo Escobar de la Garma; Arturo Ayala Arcipreste; Felipe Padilla Vázquez; Ricardo Ramírez Aguilar; Uriel Oliva Castruita; Rafael Mendizábal Guerra Journal: Surg Neurol Int Date: 2014-07-24
Authors: Walter Stummer; Floriano Rodrigues; Philippe Schucht; Matthias Preuss; Dorothee Wiewrodt; Ulf Nestler; Marco Stein; José Manuel Cabezudo Artero; Nunzio Platania; Jane Skjøth-Rasmussen; Alessandro Della Puppa; John Caird; Søren Cortnum; Sam Eljamel; Christian Ewald; Laura González-García; Andrew J Martin; Ante Melada; Aurelia Peraud; Angela Brentrup; Thomas Santarius; Hans Herbert Steiner Journal: Acta Neurochir (Wien) Date: 2014-09-24 Impact factor: 2.216