Haemangioblastomas are hypervascularized tumours. Their surgical management requires a complete resectioning and a prompt handling of the vascular inlets and outlets. The use of intraoperative indocyanine green video angiography (ICG-VAG) depicts the precise vascular pattern for the surgeon. Its use is safe and easy, and the procedure can be repeated during the operation. Here we present a case of spinal haemangioblastoma treated with the aid of intraoperative ICG-VAG and the Flow 800 software. The use of the Flow 800 allowed the surgeon to detect, at a glance, minimal changes in the vascular supply during the dissection. The colour-coded images generated by the Flow 800 increase the ICG-CAG sensitivity, improving the capability to detect changes in vascular patterns.
Sarcomas are rare tumours that commonly derive from neoplastic transformation of mesenchymal tissues. Only a small percentage of these malignancies are located in the spine. The gold standard of treatment is a multidisciplinary approach with the surgery being the most important tool. An en-bloc resection with free margins followed by radiotherapy seems to assure the best overall survival. Among the newest treatment modalities, certainly, the adrontherapy is the most interesting and promising kind of radiotherapy that uses the physical bullet properties (Bragg peak) of protons such as carbon ions to treat lesions. We present a case of a gentleman with a C2-C3 low grade osteosarcoma treated, after a biopsy tissue sample, with hadrontherapy alone. At 6 years follow up the tumour seems to be well under control.
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