Abstract General Information

Title

5-AMINOLEVULINIC ACID AND SURGICAL MARGIN ANALYSIS IN CALVARIAL METASTASIS WITH PERICRANIUM OR DURAL EXTENSION: TECHNICAL NOTE

Introduction, Objectives, Methods, Results, and Conclusion.

Metastasis to the calvarium with direct pericranium or dural infiltration may be treated
with radical surgical removal in selected cases. We describe microsurgical resection of
calvarial metastases with fluorescence-guided technique using 5-aminolevulinic acid
(5-ALA) in two female patients with breast cancer. Fluorescence findings were positive
in both cases. Margins in the scalp and dural layer were 5-ALA negative at the end of
surgical removal. Intraoperative pathology was performed in all cases to confirm if
oncological limits were free of disease. One case was 5-ALA positive in the outer layer of
the dura-mater and another in the pericranium. At the end of the removal in both cases,
the surgicalmargins were 5-ALA fluorescence-free. Intraoperative pathology confirmed
oncological limits of the resection. 5-aminolevulinic acid fluorescence-guided surgery
for calvarial metastases with pericranium and/or dural extension seems to be a safe and
reliable method to aid the surgical margins for complete removal, possibly delaying or
avoiding adjuvant irradiation for progression control.

Keywords (separated by comma on a single line)

5-aminolevulinic acid; calvarial metastases; fluorescence surgery; metastases; skull metastases; surgical margins