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13 May 2017 : Case report  Japan

New Navigation Surgery for Resection of Lymphatic Malformations Using Indocyanine Green Fluorescence Imaging

Unusual setting of medical care, Educational Purpose (only if useful for a systematic review or synthesis)

Chiyoe Shirota1A, Akinari Hinoki1F, Masataka Takahashi2B, Yujiro Tanaka1D, Takahisa Tainaka1B, Wataru Sumida1D, Naruhiko Murase1D, Kazuo Oshima1B, Ryo Shirotsuki1B, Kosuke Chiba1B, Yuji Morimoto3F, Hiroo Uchida1A

DOI: 10.12659/AJCR.903465

Am J Case Rep 2017; 18:529-531

Abstract

BACKGROUND: We used indocyanine green (ICG) fluorescence imaging to completely resect lymphatic malformations (LMs). This is the first report of navigation surgery utilizing ICG fluorescence imaging for resection of LMs.

CASE REPORT: A 15-year-old boy was diagnosed with LMs in the abdominal wall. The extent of the tumor was determined by an ultrasound, and ICG (Diagnogreen®, Daiichi-Sankyo Pharma, Tokyo, Japan) was injected subcutaneously and intradermally into the core and 2 marginal regions of the tumor (3 injections in total), respectively. During surgery, the extent of the tumor was confirmed with a photodynamic eye, and the tumor was completely resected. A fluorescent portion macroscopically estimated as normal was additionally resected and no residual fluorescence or tumor were confirmed in the remaining tissue. Abnormal lymphatic vessels were histopathologically observed in the additionally resected tissue, indicating the invasion of LMs. The surgery had a good outcome with no evidence of recurrence.

CONCLUSIONS: We performed near-infrared fluorescence-guided imaging surgery for the resection of LMs in the abdominal wall. This is a single case study; therefore, assessment of more cases is warranted for further validation. This procedure could provide significant benefit to patients requiring resection of LMs.

Keywords: Indocyanine Green, lymphangioma, optical imaging, Spectroscopy, Near-Infrared

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923