Intraoperative fluorescence for resection of hemangioblastomas

Roberto Rey-Dios, Aaron A. Cohen-Gadol

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Background: Resection of hemangioblastomas can be challenging due to their high vascularity and intimate association with neighboring cerebrovascular structures. The authors present their intraoperative findings using fluorescein angiography and fluorescence for removal of hemangioblastomas in an attempt to improve the safety and extent of resection. Methods: From April through August 2012, four patients were diagnosed with hemangioblastomas, 3 in the cerebellum and 1 in the medulla oblongata. Low-dose (4 mg/kg) sodium fluorescein was injected intravenously immediately before microdissection. The area of interest was inspected through a microscope-integrated fluorescent module. Results: In three superficially located tumors, the vascular pattern of feeding and draining vessels could be easily identified with fluorescein angiography. The resection of the tumors was guided using real-time fluorescence mode. For each patient, histopathologic examination of the lesion confirmed the diagnosis of hemangioblastoma. All samples of fluorescent tissue resected were confirmed to contain tumor. No patient experienced any complication. Conclusion: Low-dose sodium fluorescein used in conjunction with a microscope-integrated fluorescence module is a potentially useful tool for localization, vascular characterization, and resection of hemangioblastomas.

Original languageEnglish (US)
Pages (from-to)1287-1292
Number of pages6
JournalActa Neurochirurgica
Volume155
Issue number7
DOIs
StatePublished - Jul 1 2013

Keywords

  • Fluorescein
  • Fluorescence
  • Hemangioblastoma
  • Microdissection

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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