5-ALA is proven to be effective in high-grade glioma operative resection. The use of 5-ALA in WHO grade I lesions is still controversial. A 49-year-old lady was diagnosed in 2004 with a left temporal lobe lesion as an incidental finding; she was followed up clinically and radiologically. In 2016, the lesion showed contrast enhancement and she was offered surgical resection but given she is asymptomatic, she refused. In 2018, the lesion showed signs of transformation with ring contrast enhancement, increased vasogenic oedema and perfusion; the patient accepted surgery at that point. She had preoperative mapping by navigated transcranial magnetic stimulation and she had operative resection with 5-ALA. The tumour was bright fluorescent under Blue 400 filter-Zeiss Pentero 900©(Carl Zeiss Meditec)-and both bright fluorescence and pale fluorescence were resected. Postoperative MRI showed complete resection and histopathology revealed WHO grade I papillary glioneuronal tumour, negative for BRAF V600 mutation. WHO grade I papillary glioneuronal tumour may present as 5-ALA fluorescent lesions. From a clinical perspective, 5-ALA can be used to achieve complete resections in these lesions which, in most cases, can be curative.

中文翻译：

---

WHO I级乳头状胶质神经元肿瘤中的5-ALA荧光：病例报告。

5-ALA 被证明在高级别胶质瘤手术切除中是有效的。5-ALA 在 WHO I 级病变中的使用仍存在争议。一名 49 岁的女士于 2004 年被诊断为左侧颞叶病变，这是偶然发现的；她接受了临床和放射学随访。2016 年，病灶显示对比增强，她接受了手术切除，但鉴于她无症状，她拒绝了。2018年病灶呈环状对比增强、血管源性水肿和灌注增加的转化征象；那个时候病人接受了手术。她通过导航经颅磁刺激进行了术前标测，并用 5-ALA 进行了手术切除。肿瘤在 Blue 400 滤光片-Zeiss Pentero 900©(Carl Zeiss Meditec)-下呈明亮荧光，并切除了明亮荧光和淡荧光。术后 MRI 显示完全切除，组织病理学显示 WHO I 级乳头状胶质神经元肿瘤，BRAF V600 突变阴性。WHO I 级乳头状胶质神经元肿瘤可能表现为 5-ALA 荧光病变。从临床角度来看，5-ALA 可用于实现这些病变的完全切除，在大多数情况下，可以治愈。