5-Aminolevulinic acid fluorescence-guided surgery for spinal cord melanoma metastasis: a technical note

According to our research, just few studies described 5-Aminolevulinic acid (5-ALA) use for spinal injuries resection. 5-ALA is known to be especially useful in certain spinal tumor entities such as meningiomas, ependymomas, hemangiopericytomas, and metastasis of central nervous system primary tumors. In contrast, 5-ALA has limited value in other histopathological tumoral entities, as neurinomas and carcinoma metastasis. We describe a microsurgical resection of a spinal cord melanoma through fluorescence-guided technique using 5-ALA in a 36-year-old man. Strong 5-ALA tumor enhancement was evidenced, resulting in gross-total resection. To our knowledge, this is the first case of nonglial intramedullary metastasis with 5-ALA positive staining. We believe that this tool, 5-ALA, could aid in the resection, identification, and differentiation of medullary metastasis.