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The use of 5-aminolevulinic acid to assist gross total resection of pediatric astroblastoma

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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.

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Authors and Affiliations

  1. Department of Neurosurgery, Shizuoka Children’s Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan

    Yuji Agawa & Takafumi Wataya

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  1. Yuji Agawa
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  2. Takafumi Wataya
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Correspondence to Takafumi Wataya.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Agawa, Y., Wataya, T. The use of 5-aminolevulinic acid to assist gross total resection of pediatric astroblastoma. Childs Nerv Syst 34, 971–975 (2018). https://doi.org/10.1007/s00381-017-3714-5

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  • DOI: https://doi.org/10.1007/s00381-017-3714-5

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