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Acta Neurochirurgica
Published in: Acta Neurochirurgica 10/2019

01-10-2019 | Neurofibromatosis | How I Do it - Peripheral Nerves

Fluorescein-guided resection of plexiform neurofibromas: how I do it

Authors: Ignazio G. Vetrano, Veronica Saletti, Vittoria Nazzi

Published in: Acta Neurochirurgica | Issue 10/2019

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Abstract

Background

Plexiform neurofibromas (PN) can determine pain, nerve function impairment, and, when extremely large, also deformity. Surgical is often partial, with possible recurrence, and the risk of malignant transformation.

Method

We describe the surgical strategy in a case of huge multiple plexiform neurofibromas of the left arm. We attempted to achieve a safe resection under the intraoperative guidance of fluorescein, with a dedicated microscope filter (YELLOW560). This technique can be also applied to other locations.

Conclusion

Fluorescein-guided surgery, coupled with intraoperative neurophysiological monitoring, increases the safe resection rate, considering the risks of neurological deficits and the possible malignant transformation.
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Literature
1.
Cavallo C, De Laurentis C, Vetrano IG, Falco J, Broggi M, Schiariti M, Ferroli P, Acerbi F (2018) The utilization of fluorescein in brain tumor surgery: a systematic review. J Neurosurg Sci 62(6):690–703PubMed
2.
Gutmann DH, Ferner RE, Listernick RH, Korf BR, Wolters PL, Johnson KJ (2017) Neurofibromatosis type 1. Nat Rev Dis Prim 3:17004CrossRefPubMed
3.
Hara T, Inami M, Hara T (1998) Efficacy and safety of fluorescein angiography with orally administered sodium fluorescein. Am J Ophthalmol 126(4):560–564CrossRefPubMed
4.
Kim DH, Murovic JA, Tiel RL, Moes G, Kline DG (2005) A series of 397 peripheral neural sheath tumors: 30-year experience at Louisiana State University Health Sciences Center. J Neurosurg 102(2):246–255CrossRef
5.
Riccardi VM (2007) The genetic predisposition to and histogenesis of neurofibromas and neurofibrosarcoma in neurofibromatosis type 1. Neurosurg Focus 22(6):E3CrossRefPubMed
6.
Russell SM (2007) Preserve the nerve: microsurgical resection of peripheral nerve sheath tumors. Neurosurgery 61(3 Suppl):113–117 discussion 117-8PubMed
7.
8.
Tiel R, Kline D (2004) Peripheral nerve tumors: surgical principles, approaches, and techniques. Neurosurg Clin N Am 15(2):167–175CrossRefPubMed
9.
Vetrano IG, Bagatti D, Cordella R, Tramacere I, Nazzi V (2018) Intraoperative compound muscle action potentials (CMAPs) amplitude changes after decompression and neurolysis of peripheral nerves in upper limbs neuropathies: electrophysiologial considerations and relation with clinical outcome. J Neurosurg Sci. https://​doi.​org/​10.​23736/​S0390-5616.​18.​04513-7
10.
Vetrano IG, Lucarella F, Dalolio M, Di Cristofori A, Nataloni IF, Tiberio F, Gaini SM, Grimoldi N (2014) The importance of predicting factors in the surgical outcome of peripheral nerve sheath tumors. J Neurol Surg A Cent Eur Neurosurg 75(2):104–109PubMed
Metadata
Title
Fluorescein-guided resection of plexiform neurofibromas: how I do it
Authors
Ignazio G. Vetrano
Veronica Saletti
Vittoria Nazzi
Publication date
01-10-2019
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 10/2019
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-019-04038-5

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