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

• Published in: British Journal of Neurosurgery Vol. 37; no. 4; pp. 671 - 674
• Main Authors: Franzini, Andrea, Zekaj, Edvin, Bona, Alberto, Ciuffi, Andrea, Porta, Mauro, Servello, Domenico
• Format: Report
• Language: English
• Published: Taylor & Francis 04.07.2023
• Subjects: Dedicated Filter; Fluorescein; Posterior Fossa; Primary Central Nervous System Lymphoma; YELLOW 560
• ISSN: 0268-8697; 1360-046X
• DOI: 10.1080/02688697.2018.1556779

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.