The neurosurgical team of Apollo Cancer Institute performed the total resection of brain tumor using fluorescence-guided surgery in Chennai. This technique marks a significant progress in the field of Neuro-Oncological surgery as it enables removing of the tumor with high accuracy. A four-year-old girl child from Assam is healthy and living pain free after the removal of a life-threatening brain tumor 5X5 cms large (size of a tennis ball), that left her with frequent seizures.
The patient reported with multiple episodes of drop attack, around 4 to 5 times a day and was diagnosed with a malignant brain tumor called Extraventricular Ependymoma, a rare brain tumor that caused walking disorder, balance coordination and repeated seizures.
The Neurosurgery team at the Apollo Cancer Institute, Chennai performed the surgery using a new technique called Florescence Guided Surgery (FGS) to completely remove the tumor that was buried in the area of her brain causing frequent seizures. In this FGS technique a special dye is ingested an hour before the surgery, that spreads over the whole body, but the highly active cells (like tumor cells) take up the dye more as compared to normal cells. When seen under yellow 560 filter (a special filter integrated in the microscope), the tumor cells look distinctly different (fluorescence) as compared to normal cells. This guides the surgeon to clearly distinguish the tumor from the healthy areas minimizing damage to the brain and avoiding post-operative complications.
Dr. Balamurugan, Neurosurgeon, Apollo Cancer Institute, said, “This breakthrough procedure using Fluorescence guided surgery (FGS) sets the stage for us to perform the procedure with precision on young patients with centrally-located large tumors. The greatest advantage of this technique is that it clearly identifies the tumor and distinguishes it from the healthy zone helping us to remove the tumor completely”.
The histopathology of this tumour was reported as “Extraventricular Ependymoma”, which is an extremely rare tumor and only 7 cases have been reported in the literature. The life expectancy in this type of tumor is directly related to the amount of tumor resected and postoperative radiotherapy. In this case radiation therapy was a challenge due the age of patient. But we succeeded in administering 30 days of radiation to the child with sedation. Following this, child continues to be healthy and living free of pain and seizures.
