Near-infrared fluorescence imaging of a solitary fibrous tumor of the pancreas using methylene blue

Joost R van der Vorst, Alexander L Vahrmeijer, Merlijn Hutteman, Tjalling Bosse, Vincent T H B M Smit, Cornelis J H van de Velde, John V Frangioni, Bert A Bonsing, Joost R van der Vorst, Alexander L Vahrmeijer, Merlijn Hutteman, Tjalling Bosse, Vincent T H B M Smit, Cornelis J H van de Velde, John V Frangioni, Bert A Bonsing

Abstract

A 67-year-old female presented with unexplained abdominal pain. A contrast-enhanced computed tomography scan of the abdomen incidentally revealed a mass in the uncinate process of the pancreas. This mass was resected and based on histopathological findings, diagnosed as a solitary fibrous tumor (SFT) of the pancreas. A SFT is an extremely rare benign mesenchymal tumor that in 65% of cases affects the visceral pleura but can also affect extra-pleural sites. The intraoperative demarcation of pancreatic tumors, such as SFTs, can be challenging. In this report, the first clear intraoperative identification of a SFT of the pancreas in a human was shown using near-infrared fluorescence and methylene blue.

Keywords: Image-guided surgery; Methylene blue; Near-infrared fluorescence; Pancreatic solitary fibrous tumor.

Figures

Figure 1
Figure 1
Presurgical and intraoperative visualization of the pancreatic mass.
Figure 2
Figure 2
Mini-FLARE imaging system.
Figure 3
Figure 3
Intraoperative near-infrared fluorescence imaging.
Figure 4
Figure 4
Signal-to-background ratio of the solitary fibrous tumor.
Figure 5
Figure 5
Histopathological evaluation (A) and fluorescence microscopy (B).

Source: PubMed

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