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Acta Neurochirurgica

, Volume 161, Issue 10, pp 2141–2145 | Cite as

Fluorescein-guided resection of plexiform neurofibromas: how I do it

  • Ignazio G. VetranoEmail author
  • Veronica Saletti
  • Vittoria Nazzi
How I Do it - Peripheral Nerves
  • 65 Downloads
Part of the following topical collections:
  1. Peripheral Nerves

Abstract

Background

Plexiform neurofibromas (PN) can determine pain, nerve function impairment, and, when extremely large, also deformity. Surgical is often partial, with possible recurrence, and the risk of malignant transformation.

Method

We describe the surgical strategy in a case of huge multiple plexiform neurofibromas of the left arm. We attempted to achieve a safe resection under the intraoperative guidance of fluorescein, with a dedicated microscope filter (YELLOW560). This technique can be also applied to other locations.

Conclusion

Fluorescein-guided surgery, coupled with intraoperative neurophysiological monitoring, increases the safe resection rate, considering the risks of neurological deficits and the possible malignant transformation.

Keywords

Fluorescein Neurofibromatosis Peripheral nervous system tumor Plexiform neurofibroma YELLOW560 filter 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

The patient and next of kin have consented to the submission of this “How I Do It” to the journal.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Supplementary material

Supplementary Video 1

The video shows the different phases of the surgical procedures, from positioning and skin incision to the tumor removal. Preoperative MRI and intraoperative Doppler-US examination are depicted too. (MP4 253,977 kb)

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Neurosurgery Unit IIIFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
  2. 2.Developmental Neurology UnitFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly

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