[Fluorescence-guided resection with 5-aminolevulinic acid of an intramedullary tumor]. / Resección de tumor intramedular guiada por fluorescencia con ácido aminolevulínico.

Fluorescence-guided resection with 5-aminolevulinic acid (5-ALA) has demonstrated its usefulness in the resection of malignant cerebral gliomas. It also seems useful for the treatment of other types of cerebral and intramedullary neoplasms. We present the case of a patient with an intramedullary tumor in who fluorescence- guided resection was useful for intraoperative localization, definition of small tumor nodules and in order to achieve a complete resection of the tumor.

Resección de tumor intramedular guiada por fluorescencia con ácido aminolevulínico / Fluorescence-guided resection with 5-aminolevulinic acid of an intramedullary tumor

La resección guiada por fluorescencia con ácidoaminolevulínico (5-ALA) se ha demostrado útil para el tratamiento quirúrgico de los gliomas cerebrales malignos.También parece útil en el tratamiento de otros tipos de tumores, tanto cerebrales como intramedulares. Presentamos el caso de un paciente con un tumor intramedular en el que la fluorescencia con 5-ALA fue de utilidad para la localización intraoperatoria de la lesión, para la identificación de pequeños nódulos en el parénquima medular y para lograr la exéresis completa del tumor (AU)

Fluorescence-guided resection with 5-aminolevulinicacid (5-ALA) has demonstrated its usefulness in the resection of malignant cerebral gliomas. It also seems useful for the treatment of other types of cerebral and intramedullary neoplasms. We present the case of a patient with an intramedullary tumor in who fluorescence-guided resection was useful for intraoperative localization, definition of small tumor nodules and in order to achieve a complete resection of the tumor (AU)

[Intramedullary schwannomas. Report of two cases]. / Neurinomas intramedulares. Presentación de dos casos de un tumor infrecuente.

Intramedullary schwannomas are benign tumors that arise from clusters of Schwann cells embedded in the medullary parenchyma. They are very rare and account for 0.3 to 1.5 % of all spinal schwannomas. It is not known for certain why this happens, and several theories have been put forward. They do not exhibit any characteristic clinical picture, being pain the most frequent symptom. Imaging is also not specific and the correct diagnosis is attained most of the times after pathological examination. The goal of treatment must be complete removal, which is curative. We are presenting two patients in whom an intramedullary tumor was removed. The true nature of the lesions was suspected during the operation, but only after pathological examination was confirmed. A review of the literature has been undertaken, with special attention to the theories about the origin of these uncommon tumors.

Neurinomas intramedulares. Presentación de dos casos de un tumor infrecuente / Intramedullary schwannomas. Report of two cases

Los schwannomas intramedulares son tumoresbenignos derivados de células de Schwann localizadasen el parénquima medular. Son muy infrecuentes, constituyendoentre el 0,3 y el 1,5% de los schwannomasespinales. Existen varias teorías que intentan explicarla presencia de células de Schwann intramedularesa partir de las que derivarían estas neoplasias. Lasintomatología no es específica, siendo el dolor elsíntoma más frecuente, pudiéndose añadir, además,cualquier signo de afectación medular según el nivelde localización. En las pruebas de neuroimagen, la sospechade otras lesiones intramedulares de origen glialmás frecuentes hace que el diagnóstico de schwannomaintramedular sea postquirúrgico la mayoría de lasveces. El tratamiento es quirúrgico, pudiendo llevarse acabo, habitualmente, una resección completa.En este artículo presentamos dos casos de pacientesintervenidas quirúrgicamente de sendas lesionesintramedulares, que resultaron ser neurinomas. Hacemosuna revisión de otros casos publicados en la literatura,exponiendo las teorías existentes acerca del origende estos tumores poco frecuentes (AU)

Intramedullary schwannomas are benign tumorsthat arise from clusters of Schwann cells embeddedin the medullary parenchyma. They are very rare andaccount for 0.3 to 1.5 % of all spinal schwannomas. Itis not known for certain why this happens, and severaltheories have been put forward. They do not exhibitany characteristic clinical picture, being pain the mostfrequent symptom. Imaging is also not specific and thecorrect diagnosis is attained most of the times afterpathological examination. The goal of treatment mustbe complete removal, which is curative.We are presenting two patients in whom an intramedullarytumor was removed. The true nature ofthe lesions was suspected during the operation, butonly after pathological examination was confirmed. Areview of the literature has been undertaken, with specialattention to the theories about the origin of theseuncommon tumors (AU)