Photodiagnosis (PD) and
photodynamic therapy (
PDT) using the second-generation
photosensitizer talaporfin sodium together with an exciting
laser for primary intracranial malignant
tumors is well recognized in Japan, and many medical institutions are introducing this new therapeutic option. In particular, intraoperative
PDT using
talaporfin sodium for infiltrating
tumor cells in the cavity walls after the resection of
malignant glioma is now covered by health insurance after receiving governmental approvement, and this method has been recommended in therapeutic guidelines for
primary malignant brain tumors in Japan. On the other hand, experimental and clinical studies on the development of novel therapeutic strategies for malignant
spinal cord tumors have not been reported to date, although their histological features are almost identical to those of intracranial malignant
tumors. Therefore, the clinical outcomes of malignant
spinal cord tumors have been less favorable than those of malignant
brain tumors. In this report, we performed the PD and
PDT using
talaporfin sodium on a patient with a metastatic lumbar lesion that was detected on magnetic resonance image (MRI) 50 months after the resection of cerebellar
medulloblastoma who presented with
lumbago and
sciatica. We were able to detect the target lesion in the conus medullaris using a surgical microscope, and detected the disseminated
medulloblastoma cells floating in the cerebrospinal fluid using a compact fluorescence microscope. Furthermore, we performed
PDT to the resected lumbar lesion with the adjuvant
platinum-based
chemotherapy, and the patient survived a meaningful life for more than 2 years after the lumbar surgery. This report describes the first case of a human patient in whom the efficacy of PD and
PDT was demonstrated for a malignant
spinal cord tumor.