First Pediatric Use of Pegulicianine for Fluorescence-Guided Surgery in Li-Fraumeni-Associated Rhabdomyosarcoma.
Amirbahador Golchin Sani Masouleh, Yu-Jin Lee, Tulio Valdez et al.
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Case in brief
A 4-year-old boy with Li-Fraumeni syndrome and a TP53 mutation presented with a supraclavicular mass, diagnosed as embryonal rhabdomyosarcoma with anaplastic features and positive margins. Due to the high risk of radiation-induced malignancies, re-resection was performed instead of radiotherapy. The fluorescent agent pegulicianine was used intraoperatively for tumor identification, and the patient tolerated the procedure well.
What made this case unusual
This case is notable for being the first pediatric application of pegulicianine for fluorescence-guided surgery in a patient with rhabdomyosarcoma.
Diagnostic / clinical pearl
In cases of rhabdomyosarcoma with positive margins, especially in patients with Li-Fraumeni syndrome, consider re-resection and the use of fluorescence-guided techniques to minimize radiation exposure.
Why it matters
This case highlights the importance of innovative surgical techniques in managing complex pediatric oncology cases, particularly in patients with genetic predispositions to malignancies.