Photodynamic detection of a feline meningioma using 5-aminolaevulinic acid hydrochloride

Abstract

Case summary The present study describes the case of a feline meningioma that was detected using 5-aminolaevulinic acid hydrochloride (5-ALA)-induced protoporphyrin IX (PpIX) fluorescence at surgery. An extra-axial mass in the temporoparietal region was observed by MRI. Following craniectomy and durotomy, photodynamic detection (PDD) was performed for detection of the tumour. Intratumour PpIX was detected using fluorescence spectrum evaluation and high-performance liquid chromatography. PDD revealed bright fluorescence of PpIX induced by 5-ALA, facilitating fluorescence-guided resection of the tumour tissue. Postoperative examination demonstrated an intratumour PpIX protein concentration of 16.8 nmol/g, and based on histopathological findings we diagnosed the mass as meningioma. Relevance and novel information PDD using 5-ALA has been used to identify the surgical margins during resection of primary human brain tumours. Recently, we have reported post-mortem PDD using 5-ALA for a canine glioblastoma. To our knowledge, this technique has not been previously used for the detection and resection of feline brain tumours. Our findings suggest that PDD using 5-ALA is useful for intraoperative fluorescence-guided resection of malignant meningioma in cats.

Contribution of three‐dimensional printed models to neurosurgery: Description of a feline intracranial meningioma treated by rostrotentorial craniectomy

“…2,[9][10][11]18 To avoid these issues, intraoperative magnetic resonance imaging or fluorescenceguided resection have been studied in cat, but involve limitations including the duration of the procedure and possible false-negative staining. 19,20 Additionally, radiotherapy requires numerous anaesthesia events and is not associated with a better prognosis, although it is interesting for tumours in complicated/inoperable locations. 21 To help surgeons visualise the spatial relationship between the lesion and surrounding tissue and hence choose the best surgical route and check the extent of surgical resection, three-dimensional (3D) printing is of particular interest.…”

“…Also, tumour recurrence due to incomplete resection or neoplastic seeding has been suspected in about 20% of cases 2,9–11,18 . To avoid these issues, intraoperative magnetic resonance imaging or fluorescence‐guided resection have been studied in cat, but involve limitations including the duration of the procedure and possible false‐negative staining 19,20 . Additionally, radiotherapy requires numerous anaesthesia events and is not associated with a better prognosis, although it is interesting for tumours in complicated/inoperable locations 21 …”

Stability of spectrofluorimetric spectra of hematoporphyrin–serum albumin complexes: in vitro study

“…Photodynamic therapy is a minimally invasive treatment modality for a variety of malignant diseases and precancerous lesions of skin, breast, esophagus and colon, urinary bladder, head and neck [1][2][3][4][5]. Exogenously administered photosensitizer accumulates in tumors and selectively sensitizes cancer tissue to the laser light.…”

Utility of 5‐aminolaevulinic acid fluorescence‐guided endoscopic biopsy for malignant mesothelioma in a cat and dog

“…7 Recently, we reported the use of 5-ALA-PDD for detecting mammary gland and brain tumours in veterinary medicine. [8][9][10] To the best of our knowledge, however, no study has reported the use of 5-ALA-PDD to detect MM in veterinary medicine. The present study describes the use of 5-ALA-PDD for MM diagnosis in a cat and dog, as well as the effectiveness of intracavitary chemotherapy.…”

“…Recently, we reported the use of 5‐ALA‐PDD for detecting mammary gland and brain tumours in veterinary medicine 8–10 . To the best of our knowledge, however, no study has reported the use of 5‐ALA‐PDD to detect MM in veterinary medicine.…”