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Tummers QR, Boonstra MC, Frangioni JV, et al. Intraoperative near-infrared fluorescence imaging of a paraganglioma using methylene blue: A case report. Int J Surg Case Rep. 2014;6:150-3doi: 10.1016/j.ijscr.2014.12.002.
Tummers, Q. R., Boonstra, M. C., Frangioni, J. V., van de Velde, C. J., Vahrmeijer, A. L., & Bonsing, B. A. (2015). Intraoperative near-infrared fluorescence imaging of a paraganglioma using methylene blue: A case report. International journal of surgery case reports, 6150-3. https://doi.org/10.1016/j.ijscr.2014.12.002
Tummers, Quirijn R J G, et al. "Intraoperative near-infrared fluorescence imaging of a paraganglioma using methylene blue: A case report." International journal of surgery case reports vol. 6 (2015): 150-3. doi: https://doi.org/10.1016/j.ijscr.2014.12.002
Tummers QR, Boonstra MC, Frangioni JV, van de Velde CJ, Vahrmeijer AL, Bonsing BA. Intraoperative near-infrared fluorescence imaging of a paraganglioma using methylene blue: A case report. Int J Surg Case Rep. 2015;6:150-3. doi: 10.1016/j.ijscr.2014.12.002. Epub 2014 Dec 05. PMID: 25541370; PMCID: PMC4334887.
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Int J Surg Case Rep. 2015;6:150-3. doi: 10.1016/j.ijscr.2014.12.002. Epub 2014 Dec 05.

Intraoperative near-infrared fluorescence imaging of a paraganglioma using methylene blue: A case report.

International journal of surgery case reports

Quirijn R J G Tummers, Martin C Boonstra, John V Frangioni, Cornelis J H van de Velde, Alexander L Vahrmeijer, Bert A Bonsing

Affiliations

  1. Department of Surgery, Leiden, University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.
  2. Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA; Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA.
  3. Department of Surgery, Leiden, University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands. Electronic address: [email protected].

PMID: 25541370 PMCID: PMC4334887 DOI: 10.1016/j.ijscr.2014.12.002

Abstract

INTRODUCTION: Intraoperative identification of tumors can be challenging. Near-infrared (NIR) fluorescence imaging is an innovative technique that can assist in intraoperative identification of tumors, which may otherwise be undetectable.

PRESENTATION OF CASE: A 19-year-old patient with symptoms, normetanephrine levels and radiological findings suspicious for a paraganglioma, a rare tumor arising from extra-adrenal chromaffin cells within the sympathetic nervous system, is presented. Intraoperative NIR fluorescence imaging using intravenous administration of methylene blue (MB) assisted in intraoperative detection of the tumor, and even identified a smaller second lesion, which was not identified during surgery by visual inspection.

DISCUSSION: Although the exact mechanism of MB accumulation in neuroendocrine tumors is unclear, it is described in both preclinical and clinical studies.

CONCLUSION: In this report, we describe the first case of intraoperative NIR fluorescence imaging of a paraganglioma using MB, which identified an otherwise undetectable lesion.

Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Keywords: Image-guided surgery; Methylene blue; Near-infrared fluorescence imaging; Neuroendocrine tumor; Paraganglioma

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