Abstract：
A major challenge in the surgical resection of brainstem tumors is distinguishing tumor from normal tissue. One approach for addressing this problem is the use of fluorescent tracers such as sodium fluorescein (NaFl). NaFl disseminates through a disruption in the blood-brain barrier (BBB) and accumulates in the extracellular space of brain tumors. Intraoperative fluorescence microscopy can be performed to identify tumor tissue and avoid damage to adjacent, normal tissue. Here, we present the case of a 16-year-old male who underwent a left retrosigmoid craniotomy with splitting of the tentorium to remove a large exophytic brainstem tumor involving the cerebellar peduncle and with superior extension into the midbrain and thalamus.
The primary objective of this study was to investigate the effectiveness of sodium fluorescein as an intraoperative technique and evaluate its potential benefit for resection of tumors in eloquent regions in the pediatric population. To do so, we focused on a case study approach; however, we also performed a literature review and evaluated different intraoperative fluorescent techniques and their benefits for tumor resection.
We performed a literature search using PubMed and Google Scholar by the key words \"sodium fluorescein,\" \"brain stem tumor,\" and \"central nervous system neoplasms.\" Twenty-nine articles including both pediatric and adult populations were selected for analysis and qualitative review.
In this case study, sodium fluorescein helped the surgeons to identify and obtain a gross total resection of a large brainstem tumor. The marker was especially helpful for discerning the inferior pole of the tumor buried inconspicuously in cerebellar tissue. We evaluate different fluorescent tracers, 5-ALA and ICG, and discuss their application and benefits in tumor resection surgery. We present different cases that found sodium fluorescein to be helpful in achieving a gross total resection.
The application of sodium fluorescein proved to be a safe and effective technique for the resection of brain stem tumors as shown in this case study. It helped to expose concealed areas and illuminate the tumor capsule. Further studies should test the clinical use of sodium fluorescein on brain stem tumor resection.
The primary objective of this study was to investigate the effectiveness of sodium fluorescein as an intraoperative technique and evaluate its potential benefit for resection of tumors in eloquent regions in the pediatric population. To do so, we focused on a case study approach; however, we also performed a literature review and evaluated different intraoperative fluorescent techniques and their benefits for tumor resection.
We performed a literature search using PubMed and Google Scholar by the key words \"sodium fluorescein,\" \"brain stem tumor,\" and \"central nervous system neoplasms.\" Twenty-nine articles including both pediatric and adult populations were selected for analysis and qualitative review.
In this case study, sodium fluorescein helped the surgeons to identify and obtain a gross total resection of a large brainstem tumor. The marker was especially helpful for discerning the inferior pole of the tumor buried inconspicuously in cerebellar tissue. We evaluate different fluorescent tracers, 5-ALA and ICG, and discuss their application and benefits in tumor resection surgery. We present different cases that found sodium fluorescein to be helpful in achieving a gross total resection.
The application of sodium fluorescein proved to be a safe and effective technique for the resection of brain stem tumors as shown in this case study. It helped to expose concealed areas and illuminate the tumor capsule. Further studies should test the clinical use of sodium fluorescein on brain stem tumor resection.
摘要：
脑干肿瘤手术切除的主要挑战是将肿瘤与正常组织区分开。解决该问题的一种方法是使用荧光示踪剂如荧光素钠(NaFl)。NaFl通过破坏血脑屏障(BBB)而传播并在脑肿瘤的细胞外间隙中积累。术中荧光显微镜可用于识别肿瘤组织，避免损伤邻近，正常组织。这里,我们介绍了一例16岁的男性，他接受了左乙状结肠后开颅手术，并劈开了幕部，以切除一个涉及小脑柄的大型外生性脑干肿瘤，并向上延伸到中脑和丘脑。
本研究的主要目的是研究荧光素钠作为术中技术的有效性，并评估其对儿科人群雄辩区域肿瘤切除的潜在益处。要做到这一点，我们专注于案例研究方法；然而，我们还进行了文献综述,并评估了不同的术中荧光技术及其对肿瘤切除的益处.
我们使用PubMed和GoogleScholar通过关键词“荧光素钠，脑干肿瘤,“和”中枢神经系统肿瘤。“选择了29篇包括儿童和成人人群的文章进行分析和定性审查。
在这个案例研究中,荧光素钠有助于外科医生识别并获得大型脑干肿瘤的总切除。该标记物特别有助于辨别隐藏在小脑组织中的肿瘤的下极。我们评估不同的荧光示踪剂，5-ALA和ICG，并讨论其在肿瘤切除手术中的应用和效益。我们介绍了发现荧光素钠有助于实现总体全切除的不同病例。
如本案例研究所示，荧光素钠的应用被证明是切除脑干肿瘤的安全有效的技术。它有助于暴露隐藏区域并照亮肿瘤囊。进一步的研究应测试荧光素钠在脑干肿瘤切除术中的临床使用。
本研究的主要目的是研究荧光素钠作为术中技术的有效性，并评估其对儿科人群雄辩区域肿瘤切除的潜在益处。要做到这一点，我们专注于案例研究方法；然而，我们还进行了文献综述,并评估了不同的术中荧光技术及其对肿瘤切除的益处.
我们使用PubMed和GoogleScholar通过关键词“荧光素钠，脑干肿瘤,“和”中枢神经系统肿瘤。“选择了29篇包括儿童和成人人群的文章进行分析和定性审查。
在这个案例研究中,荧光素钠有助于外科医生识别并获得大型脑干肿瘤的总切除。该标记物特别有助于辨别隐藏在小脑组织中的肿瘤的下极。我们评估不同的荧光示踪剂，5-ALA和ICG，并讨论其在肿瘤切除手术中的应用和效益。我们介绍了发现荧光素钠有助于实现总体全切除的不同病例。
如本案例研究所示，荧光素钠的应用被证明是切除脑干肿瘤的安全有效的技术。它有助于暴露隐藏区域并照亮肿瘤囊。进一步的研究应测试荧光素钠在脑干肿瘤切除术中的临床使用。
