Brain Tumor Pathology

, Volume 24, Issue 2, pp 53–55 | Cite as

Fluorescence-guided resection of metastatic brain tumors using a 5-aminolevulinic acid-induced protoporphyrin IX: pathological study

  • Satoshi UtsukiEmail author
  • Norio Miyoshi
  • Hidehiro Oka
  • Yoshiteru Miyajima
  • Satoru Shimizu
  • Sachio Suzuki
  • Kiyotaka Fujii


We performed a pathological study to identify the locus of production of protoporphyrin IX (PPIX) in human metastatic brain tumors. Patients with metastatic brain tumors (n = 11) received 1 g of 5-aminolevulinic acid (5-ALA) perorally 2 h before undergoing surgery. The target region was exposed to laser light with a peak wavelength of 405 ± 1 nm and an output of 40 mW. Tissue samples from the tumor bulk and surrounding areas were examined by histological and fluorescence methods. Of the 11 tumors, 9 manifested PPIX fluorescence in the tumor bulk and peritumoral brain tissue. Our findings indicate that PPIX fluorescence can be observed in peritumoral edematous areas that are free of neoplastic cells, because PPIX produced by neoplastic cells leaks into the surrounding edematous area.

Key words

5-Aminolevulinic acid Fluorescence diagnosis Metastatic brain tumor Protoporphyrin IX 


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Copyright information

© The Japan Society of Brain Tumor Pathology 2007

Authors and Affiliations

  • Satoshi Utsuki
    • 1
    Email author
  • Norio Miyoshi
    • 2
  • Hidehiro Oka
    • 1
  • Yoshiteru Miyajima
    • 1
  • Satoru Shimizu
    • 1
  • Sachio Suzuki
    • 1
  • Kiyotaka Fujii
    • 1
  1. 1.Department of NeurosurgeryKitasato University School of MedicineKanagawaJapan
  2. 2.Department of Pathology, Faculty of MedicineUniversity of FukuiFukuiJapan

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