Fluorescein sodium-guided resection of a cerebellar lymphoma: case report and literature review

Abstract

We report on a patient, who underwent the resection of a cerebellar primary central nervous system lymphoma and was administered intraoperative fluorescein sodium to improve the visualization of the tumor and guide surgery. Low-dosage fluorescein was administered prior to opening the dura so to distinguish contrast-enhanced lymphomatous tissue from the surrounding unenhanced brain cerebellar parenchyma. Intraoperatively, the tumor was indistinguishable from cerebellar parenchyma under the white light, however, after the administration of low-dose intravenous fluorescein, it appeared brightly fluorescent under yellow light, and was safely resected. Our protocol of administration allowed for the sampling of the pathological tissue while at the same time avoiding neurological damage. The fluorescein-guided technique for the resection of primary central nervous system lymphomas has only been rarely described, as surgical excision of such tumors is rarely indicated. Starting from our case, we review and discuss the pertinent literature. Furthermore, an intraoperative video detail is provided.

Keywords:

• Fluorescein
• Primary Central Nervous System Lymphoma
• Posterior Fossa
• YELLOW 560
• Dedicated Filter

Acknowledgements

This work was supported by Galeazzi Research and Clinical Hospital; via Riccardo Galeazzi 4, 20161, Milan, Italy.

Disclosure statement

There are no conflict of interests to report or financial disclosures related to this manuscript.

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The patient has consented to submission of this case report to the journal.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.