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. 2021 Jul 30;11:699301. doi: 10.3389/fonc.2021.699301

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Copyright © 2021 Kiesel, Freund, Reichert, Wadiura, Erkkilae, Woehrer, Hervey-Jumper, Berger and Widhalm

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Illustrative case of a patient with a suspected low-grade glioma (LGG) with surgical resection after 5-ALA administration. (A) Magnetic resonance imaging of a 43-year-old male patient reveals a suspected LGG in the left frontal lobe. On T1-weighted sequences no significant contrast-media enhancement is observed. (B, C) On fluid-attenuated inversion recovery (FLAIR) and T2-weighted sequences the lesion is hyperintense. (D) Perfusion imaging shows no hyperperfusion. (E) During surgical tumor resection, conventional white-light microscopy was used. (F) Additionally, the microscope was repeatedly switched to violet-blue excitation light and an intratumoral area of visible fluorescence was detected. (G) Histopathological analysis revealed an anaplastic astrocytoma WHO grade III (IDH mutated).