title: Fluorescence-guided resection of extracranial soft tissue tumour infiltration in atypical meningioma.
abstract: The exact role of 5-aminolevulinic acid (5-ALA) fluorescence-guided meningioma resection is as yet unclear. Although most of the meningiomas show positive fluorescence, the influence on outcome, fluorescence heterogeneity within the tumour, the correlation between fluorescence and the proliferation rate, as well as different quantitative measurements are a matter of debate. Positive fluorescence in bone infiltrative meningiomas is well described, whereas little data exist about 5-ALA fluorescence within soft tissue infiltration. We add a case of histologically confirmed fluorescent tumour infiltration into soft tissue. A 78-year-old woman underwent resection of an atypical meningioma at the University Hospital of St. Poelten. Preoperative imaging showed tumour infiltration throughout the calvaria. 5-ALA fluorescence of the tumour as well as bone, periost and temporal muscle helped to perform a gross total resection. Histological examination showed an atypical meningioma (WHO Grade II) and gave proof of tumour infiltration of the bone and temporal muscle. With the aid of 5-ALA fluorescence, a gross total resection could be performed.
authors.affiliation: Department of Neurosurgery, University Hospital of St. Poelten, Propst-Fuehrer-Straße 4, 3130, St. Pölten, Lower Austria, Austria.
authors.forename: Florian
authors.initials: F
authors.lastname: Scheichel
authors.affiliation: Department of Neurosurgery, University Hospital of St. Poelten, Propst-Fuehrer-Straße 4, 3130, St. Pölten, Lower Austria, Austria.
authors.forename: Karl
authors.initials: K
authors.lastname: Ungersboeck
authors.affiliation: Department of Pathology, University Hospital of St. Poelten, Propst-Fuehrerstrasse 4, St. Poelten, 3100 St. Poelten, Lower Austria, Austria.
authors.forename: Melitta
authors.initials: M
authors.lastname: Kitzwoegerer
authors.affiliation: Department of Neurosurgery, University Hospital of St. Poelten, Propst-Fuehrer-Straße 4, 3130, St. Pölten, Lower Austria, Austria. Franz.Marhold@stpoelten.lknoe.at.
authors.forename: Franz
authors.initials: F
authors.lastname: Marhold
mesh_terms: D000368:Aged; D005260:Female; D005453:Fluorescence; D006801:Humans; D008577:Meningeal Neoplasms / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D012983:Soft Tissue Neoplasms / Q000556:secondary / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000379:methods*
keywords: 5-ALA; Atypical meningioma; Bone invasion; Fluorescence-guided resection