Utility of indocyanine green in the detection of radiologically silent hemangioblastomas: case report.

Details

Serval ID
serval:BIB_5D418493F0E7
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Utility of indocyanine green in the detection of radiologically silent hemangioblastomas: case report.
Journal
Journal of neurosurgery
Author(s)
Ryba A.S., Sales-Llopis J., Wolfsberger S., Laakso A., Daniel R.T., González-López P.
ISSN
1933-0693 (Electronic)
ISSN-L
0022-3085
Publication state
Published
Issued date
12/02/2021
Peer-reviewed
Oui
Volume
135
Number
4
Pages
1173-1179
Language
english
Notes
Publication types: Case Reports
Publication Status: epublish
Abstract
Hemangioblastomas (HBs) are rare, benign, hypervascularized tumors. Fluorescent imaging with indocyanine green (ICG) can visualize tumor angioarchitecture. The authors report a case of multiple HBs involving two radiologically silent lesions only detected intraoperatively by ICG fluorescence. A 26-year-old woman presented with a cystic cerebellar mass on the tentorial surface of the left cerebellar hemisphere on MRI. A left paramedian suboccipital approach was performed to remove the mural nodule with the aid of ICG injection. The first injection, applied just prior to removing the nodule, highlighted the tumor and vessels. After resection, two new lesions, invisible on the preoperative MRI, surprisingly enhanced on fluorescent imaging 35 minutes after the ICG bolus. Both silent lesions were removed. Histological analysis of all three lesions revealed they were positive for HB. The main goal of this report is to hypothesize possible explanations about the mechanism that led to the behavior of the two silent lesions. Intraoperative ICG videoangiography was useful to understand the 3D angioarchitecture and HB flow patterns to perform a safe and complete resection in this case. Understanding the HB ultrastructure and pathophysiological mechanisms, in conjunction with the properties of ICG, may expand potential applications for their diagnosis and future treatments.
Keywords
hemangioblastoma, indocyanine green, radiologically silent, surgical technique
Pubmed
Web of science
Create date
22/02/2021 12:26
Last modification date
25/05/2023 6:54
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