INTRODUCTION: Malignant gliomas remain associated with a poor prognosis despite 
both surgical treatment and radiochemotherapy.Previous studies have shown that 
complete resection of contrast-enhancing tumours is achieved in less than 20-30% 
of patients. 5-aminolevulinic acid (5-ALA) is a pro-drug that leads to 
accumulation of fluorescent protoporphyrins in malignant gliomas. The 
fluorescence can be visualized intraoperatively by use of a modified microscope. 
The Department of Neurosurgery at Aalborg Hospital has recently adopted this new 
technique as the first centre in Denmark. Our preliminary results are presented 
as a retrospective case series.
MATERIAL AND METHODS: All patients who had undergone 5-ALA fluorescence-guided 
surgery due to suspected malignant glioma were included. Patients received a 
standard preoperative dose of Gliolan. All patients had a postoperative cerebral 
magnetic resonance imaging scan done within 72 hours to determine their 
postoperative resection status.
RESULTS: To date, 13 patients have undergone fluorescence-guided surgery. Total 
resection was achieved in 54-70% of the patients depending on the inclusion 
criteria. Total or near total resection was achieved in 92% of patients.
CONCLUSION: The small numbers in our case series do not allow for direct 
comparison to be made, but show that our results on postoperative resection 
status fall within the range reported in other studies on the efficacy of 5-ALA. 
The literature offers mounting evidence in support of the role of aggressive 
cytoreductive surgery in patients with malignant gliomas.
FUNDING: not relevant.
TRIAL REGISTRATION: not relevant.