5-ALA

Some tumors are difficult to remove completely because the margins of the tumor look similar to normal brain tissue.

This is especially true for infiltrative gliomas, which invade neighboring tissue as individual cells or small groups of tumor cells that can spread out over a wide area. In these cases, use of 5-ALA can help neurosurgeons find tumor cells that lie outside the margins of the tumor.

5-aminolevulinic acid causes tumor cells to fluoresce, making them easier to remove — 5-ALA causes tumor cells to become fluorescent (red), making them easier to see and remove

5-ALA is a compound (swallowed by the patient before the surgery, in a liquid solution) that causes malignant glioma cells to fluoresce. Using a modified neurosurgical microscope, the neurosurgeon can more easily identify and remove the main tumor mass, in addition to small clusters of tumor cells outside of the tumor margins.

This content was reviewed by UCSF neurosurgeons, Mitchel Berger, MD and Shawn Hervey-Jumper, MD.