Our Summary

This research paper describes a surgical approach for treating a condition called Plexiform Neurofibromas (PN). PN are complex nerve tumors that can cause pain, impair nerve function, and even cause deformities when they grow extremely large. Surgery for this condition is often only partially successful, and there’s a risk of recurrence and the tumors becoming cancerous.

In this study, they used a surgical method guided by a substance called fluorescein, using a specific microscope filter (known as YELLOW560). This method was used on a patient with multiple large PN in their left arm.

The main conclusion of the study is that this fluorescein-guided surgery, along with monitoring of the patient’s neurological condition during the operation, can increase the chances of safely removing such tumors. This is particularly important given the risks of neurological damage and potential malignancy associated with PN. This technique can also be applied to remove tumors in other parts of the body.

FAQs

  1. What is plexiform neurofibroma and how does it affect the body?
  2. What is the role of fluorescein in the surgical strategy of plexiform neurofibromas?
  3. How does fluorescein-guided surgery increase the safe resection rate of plexiform neurofibromas?

Doctor’s Tip

One helpful tip a doctor might tell a patient about tumor resection is to discuss the possibility of using fluorescein-guided surgery, along with intraoperative neurophysiological monitoring, to increase the safety and effectiveness of the procedure. This technique can help ensure a more complete resection of the tumor while minimizing the risk of neurological deficits and potential malignant transformation. It is important for the patient to understand the benefits and risks of this approach and to follow any pre- and post-operative care instructions provided by their healthcare team.

Suitable For

Patients with huge, multiple plexiform neurofibromas that are causing pain, nerve function impairment, and deformity are typically recommended for tumor resection. In cases where the tumor is extremely large and there is a risk of malignant transformation, surgical intervention may be necessary. The use of fluorescein-guided surgery, coupled with intraoperative neurophysiological monitoring, can increase the safe resection rate and minimize the risk of neurological deficits. This technique can be applied to other locations as well, not just the left arm as described in the case study.

Timeline

Before tumor resection:

  • Patient may experience pain, nerve function impairment, and deformity due to the presence of the plexiform neurofibromas.
  • Surgical intervention may be necessary to address these symptoms.
  • Preoperative evaluations and imaging studies are conducted to assess the extent of the tumor and plan the surgical approach.

After tumor resection:

  • The surgical strategy involves the use of fluorescein guidance and a dedicated microscope filter to achieve a safe resection.
  • Intraoperative neurophysiological monitoring is utilized to reduce the risk of neurological deficits.
  • The goal of the surgery is to safely remove the tumors while minimizing the risk of recurrence and malignant transformation.
  • Postoperative care and follow-up monitoring are essential to assess the patient’s recovery and address any potential complications.

What to Ask Your Doctor

  1. What are the risks and benefits of tumor resection surgery for my specific case?
  2. How will the surgery be performed and what techniques will be used to ensure a safe resection?
  3. Will intraoperative guidance of fluorescein be used during the surgery? How does this technique work and what are the potential benefits?
  4. What is the role of intraoperative neurophysiological monitoring in ensuring a safe resection?
  5. What is the likelihood of recurrence of the tumor after surgery?
  6. Are there any alternative treatment options available for my condition?
  7. What is the expected recovery time and rehabilitation process after tumor resection surgery?
  8. What are the potential long-term effects or complications of the surgery?
  9. How often will I need follow-up appointments after the surgery?
  10. What signs or symptoms should I watch for after surgery that may indicate a complication or recurrence of the tumor?

Reference

Authors: Vetrano IG, Saletti V, Nazzi V. Journal: Acta Neurochir (Wien). 2019 Oct;161(10):2141-2145. doi: 10.1007/s00701-019-04038-5. Epub 2019 Aug 21. PMID: 31435825