Brain Tumor Res Treat.  2023 Jul;11(3):216-218. 10.14791/btrt.2023.0014.

Delayed Detection of a 5-Aminolevulinic Acid In Vivo: A Case of Metastatic Breast Cancer

• Kim HM
• Lee MH
• Lee TK

• KMID: 2545119
• DOI: http://doi.org/10.14791/btrt.2023.0014

Abstract

A 44-year-old female patient who had been diagnosed with breast cancer visited our oncology department. She had developed right-side weakness and mild dysarthria, and MRI revealed a 4-cm cysticenhancing lesion in her left frontal lobe. Her surgery was postponed 48 hours after receiving 5-aminolevulinic acid (5-ALA), because a problem with thyroid function that had not been noticed before was discovered. The main lesion was enhanced on navigation and appeared to be a gross tumor; its 5-ALA uptake was very high. Specimens obtained from this location were histologically confirmed to contain tumor cells. The operation was completed, and removal of all enhancing lesions was confirmed by MRI within 24 hours postoperatively. The pathology report confirmed metastatic ductal carcinoma. The clinical efficacy of 5-ALA was confirmed even 48 hours after administration into a metastatic brain tumor from breast cancer.

Keyword

Aminolevulinic acid; Brain Neoplasms; Carcinoma, ductal; Breast

Figure

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  Fig. 1 A 44-year-old female patient underwent tumor resection 48 hours after oral administration of 5-aminolevulinic acid (5-ALA). During the procedure, the main lesion was enhanced on navigation and appeared to be a gross tumor; its 5-ALA uptake was also very high. Specimens obtained from this location were histologically confirmed to contain tumor cells (red dot). At the posterior margin, a tumor was grossly suspected, but there was no 5-ALA uptake. In the specimen obtained from this position, tumor cells could not be confirmed histologically (yellow dot). At the inferior margin, there was almost no 5-ALA uptake, and tumor cells could not be confirmed histologically (blue dot) in this area.

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