• Leonardo Gilmone Ruschel, Ricardo Ramina, Erasmo Barros da Silva, Marcella Santos Cavalcanti, and Joel Fernando Sanabria Duarte.
• Neurosurgery Department, Neurological Institute of Curitiba (INC), Curitiba, Paraná, Brazil. leonardoruschel@yahoo.com.br.
• Acta Neurochir (Wien). 2018 Oct 1; 160 (10): 1905-1908.

BackgroundAccording to our research, just few studies described 5-Aminolevulinic acid (5-ALA) use for spinal injuries resection. 5-ALA is known to be especially useful in certain spinal tumor entities such as meningiomas, ependymomas, hemangiopericytomas, and metastasis of central nervous system primary tumors. In contrast, 5-ALA has limited value in other histopathological tumoral entities, as neurinomas and carcinoma metastasis.MethodWe describe a microsurgical resection of a spinal cord melanoma through fluorescence-guided technique using 5-ALA in a 36-year-old man.ResultsStrong 5-ALA tumor enhancement was evidenced, resulting in gross-total resection.ConclusionTo our knowledge, this is the first case of nonglial intramedullary metastasis with 5-ALA positive staining. We believe that this tool, 5-ALA, could aid in the resection, identification, and differentiation of medullary metastasis.

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