title: Intra-operative 5-aminolevulinic acid (ALA)-induced fluorescence of medulloblastoma: phenotypic variability and CD133(+) expression according to different fluorescence patterns.
abstract: 5-Aminolevulinic acid (5-ALA) fluorescence has been proved advantageous in glioma surgery. Conflicting results have been reported by few studies published in literature about intra-operative 5-ALA-induced fluorescence of medulloblastoma (MDB). The aim of this study is to verify if these conflicting results could be explained by intra-tumoral histological and phenotypic differences. In the present case of a 45-year-old patient affected by a cerebellar MDB, histological analysis of cell phenotype and 5-ALA and CD133 correlation were performed in multiple samples according to different fluorescence patterns. Intra-operatively, the tumor appeared unevenly fluorescent under blue-violet light. Histologically, 5-ALA-intense biopsies from inner areas were characterized by a significant amount of cancer cells, whereas 5-ALA faint regions from peripheral areas displayed normal cerebellar features, with MDB cells infiltrating healthy tissues. Presenting our findings, we show the correlation between different 5-ALA fluorescence patterns of medulloblastoma with specific histological and phenotypical features. Thus, we hypothesize that a distinct relationship between CD133 expression and fluorescence accumulation presented in our study could partially explain the divergent results published in literature.
authors: Department of Neurosurgery, Padua University Hospital, Azienda Ospedaliera di Padova, via Giustiniani, 2, 35128, Padua, Italy, alessandro.dellapuppa@sanita.padova.it.
authors: Alessandro
authors: A
authors: Della Puppa
authors: Giorgio
authors: G
authors: Gioffrè
authors: Marina Paola
authors: MP
authors: Gardiman
authors: Chiara
authors: C
authors: Frasson
authors: Diego
authors: D
authors: Cecchin
authors: Renato
authors: R
authors: Scienza
authors: Luca
authors: L
authors: Persano
mesh_terms: D000071916:AC133 Antigen; D000622:Aminolevulinic Acid; D015703:Antigens, CD / Q000096:biosynthesis*; D002528:Cerebellar Neoplasms / Q000378:metabolism* / Q000601:surgery; D005456:Fluorescent Dyes; D006023:Glycoproteins / Q000096:biosynthesis*; D006801:Humans; D008297:Male; D008527:Medulloblastoma / Q000378:metabolism* / Q000601:surgery; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D010455:Peptides; D010641:Phenotype
chemical_list: D000071916:AC133 Antigen; D015703:Antigens, CD; D005456:Fluorescent Dyes; D006023:Glycoproteins; C000606023:PROM1 protein, human; D010455:Peptides; D000622:Aminolevulinic Acid