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Photodynamic detection of a feline meningioma using 5-aminolaevulinic acid hydrochloride
Tomohiro Osaki1, Kengo Gonda1, Yusuke Murahata1
1Joint Department of Veterinary Medicine, Faculty of Agriculture, Tottori University, Tottori, Japan.
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.
Insights
Photodynamic detection using 5-aminolaevulinic acid hydrochloride (5-ALA) successfully identified feline meningioma during surgery. This fluorescence-guided technique aids in precise tumor resection, improving outcomes for brain tumor treatment in cats.
Area of Science:
- Veterinary Neurology
- Surgical Oncology
- Biomedical Optics
Background:
- Meningiomas are common extra-axial brain tumors in cats.
- Accurate surgical resection is crucial for optimal patient outcomes.
- Novel imaging techniques are needed to improve intraoperative tumor margin definition.
Observation:
- A feline patient presented with an extra-axial mass in the temporoparietal region, diagnosed via MRI.
- 5-aminolaevulinic acid hydrochloride (5-ALA) was administered to induce protoporphyrin IX (PpIX) fluorescence.
- Photodynamic detection (PDD) was employed during surgery to visualize tumorous tissue.
Findings:
- PDD revealed bright PpIX fluorescence within the feline meningioma, enabling fluorescence-guided resection.
- High-performance liquid chromatography confirmed intratumoral PpIX concentration of 16.8 nmol/g.
- Histopathological examination confirmed the mass as a meningioma.
Implications:
- This study demonstrates the utility of 5-ALA-induced PDD for intraoperative feline meningioma detection and resection.
- The technique facilitates precise tumor margin identification, potentially leading to more complete surgical removal.
- 5-ALA-induced PDD represents a promising advancement for neurosurgery in veterinary medicine, particularly for brain tumors in cats.
