MR-guided Laser Interstitial Thermal Therapy mesencephalotomy for medically intractable malignant pain

Stereotactic mesencephalotomy is a neurosurgical technique designed to sever spinothalamic pain transmission pathways for medically intractable pain. This report presents the first case of Magnetic Resonance-guided Laser Interstitial Thermal Therapy (MRgLITT) mesencephalotomy for severe malignant pain due to metastatic melanoma. The procedure significantly reduced the patient's pain, with a postoperative visual analog scale (VAS) score decreasing from > 7 to < 3. No adverse effects were observed. The case underscores the potential of MRgLITT mesencephalotomy as a precise, minimally invasive option for pain management in palliative care settings.