{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T11:07:52Z","timestamp":1779361672143,"version":"3.51.4"},"reference-count":20,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"17","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,4,27]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>An intramedullary spinal cord clear cell meningioma (CCM) is an exceptionally rare diagnosis; there are only 2 similar cases reported in the literature. The authors present a case of an intramedullary spinal cord CCM that was successfully resected with the assistance of sodium fluorescein to guide resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>\n                      A 68-year-old male presented with gait instability, decreased sensation, and loss of proprioception in the lower extremities, concerning for thoracic myelopathy. MRI of the thoracic spine revealed an intradural, intramedullary contrast-enhancing mass most concerning for a spinal ependymoma or astrocytoma. Given his progressive neurological decline, need for tissue diagnosis, and tumor cytoreduction, fluorescence-guided resection of the mass was performed. Postoperative pathological analysis demonstrated the presence of polygonal tumor cells with clear cytoplasm that harbored a known pathogenic\n                      <jats:italic>SMARCE1<\/jats:italic>\n                      frameshift mutation that supported the diagnosis of an intramedullary CCM.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>The authors present the first reported case of a fluorescence-guided resection of an intramedullary CCM.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE251031\">https:\/\/thejns.org\/doi\/10.3171\/CASE251031<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case251031","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T10:39:47Z","timestamp":1779359987000},"source":"Crossref","is-referenced-by-count":0,"title":["Sodium fluorescein\u2013guided resection of an intramedullary spinal cord clear cell meningioma: illustrative case"],"prefix":"10.3171","volume":"11","author":[{"given":"Zabiullah","family":"Bajouri","sequence":"first","affiliation":[{"name":"Department of Surgery, Section of Neurosurgery, Dartmouth Health, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4409-8615","authenticated-orcid":true,"given":"Oliver","family":"Kirsch","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Neurosurgery, Dartmouth College, Hanover"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vishva","family":"Natarajan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Neurosurgery, Geisel School of Medicine at Dartmouth, Hanover"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Mazof","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Neurosurgery, Geisel School of Medicine at Dartmouth, Hanover"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6829-7317","authenticated-orcid":true,"given":"Stephanie A.","family":"Ihezie","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Neurosurgery, Dartmouth Health, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9679-4287","authenticated-orcid":true,"given":"Chun-Chieh","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Dartmouth Health, Lebanon, New Hampshire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George J.","family":"Zanazzi","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Dartmouth Health, Lebanon, New Hampshire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linton T.","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Neurosurgery, Dartmouth Health, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"1","key":"bib1","series-title":"Neurosurg Rev","first-page":"35","article-title":"Central nervous system clear cell meningioma: a systematic literature review","volume":"47","author":"Liang","year":"2024","unstructured":"Liang QGe PLiu YCentral nervous system clear cell meningioma: a systematic literature review. Neurosurg Rev. 2024;47(1):35. doi:10.1007\/s10143-023-02251-6"},{"key":"bib2","series-title":"World Neurosurg","first-page":"11","article-title":"Spinal intramedullary meningiomas: a systematic review with a case illustration","volume":"187","author":"Garufi","year":"2024","unstructured":"Garufi GScalia GRicciardo GUmana GEConti ACardali SM.Spinal intramedullary meningiomas: a systematic review with a case illustration. World Neurosurg. 2024;187:11-18. doi:10.1016\/j.wneu.2024.03.124"},{"issue":"3","key":"bib3","series-title":"Pediatr Dev Pathol","first-page":"386","article-title":"Clear cell meningioma: case report and review of the literature","volume":"8","author":"Oviedo","year":"2005","unstructured":"Oviedo APang DZovickian JSmith M.Clear cell meningioma: case report and review of the literature. Pediatr Dev Pathol. 2005;8(3):386-390. doi:10.1007\/s10024-005-0119-3"},{"issue":"4","key":"bib4","series-title":"Acta Neurochir (Wien)","first-page":"463","article-title":"Intramedullary clear cell meningioma","volume":"148","author":"Park","year":"2006","unstructured":"Park SHHwang SKPark YM.Intramedullary clear cell meningioma. Acta Neurochir (Wien). 2006;148(4):463-466. doi:10.1007\/s00701-005-0695-z"},{"issue":"3","key":"bib5","series-title":"Surg Neurol","first-page":"285","article-title":"Intraspinal clear-cell meningioma: case report and review of literature","volume":"63","author":"Liu","year":"2005","unstructured":"Liu PILiu GCTsai KBLin CLHsu JS.Intraspinal clear-cell meningioma: case report and review of literature. Surg Neurol. 2005;63(3):285-288. doi:10.1016\/j.surneu.2004.03.013"},{"issue":"2","key":"bib6","series-title":"Acta Neuropathol","first-page":"281","article-title":"Clear cell meningiomas are defined by a highly distinct DNA methylation profile and mutations in SMARCE1","volume":"141","author":"Sievers","year":"2021","unstructured":"Sievers PSill MBlume CClear cell meningiomas are defined by a highly distinct DNA methylation profile and mutations in SMARCE1. Acta Neuropathol. 2021;141(2):281-290. doi:10.1007\/s00401-020-02247-2"},{"issue":"1","key":"bib7","series-title":"Neurosurgery","first-page":"218","article-title":"Intraspinal clear cell meningioma: diagnosis and management: report of two cases","volume":"48","author":"Jallo","year":"2001","unstructured":"Jallo GIKothbauer KFSilvera VMEpstein FJ.Intraspinal clear cell meningioma: diagnosis and management: report of two cases. 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Surg Neurol. 2005;63(3):285-288. doi:10.1016\/j.surneu.2004.03.013"},{"issue":"2","key":"bib6","series-title":"Acta Neuropathol","first-page":"281","article-title":"Clear cell meningiomas are defined by a highly distinct DNA methylation profile and mutations in SMARCE1","volume":"141","author":"Sievers","year":"2021","unstructured":"Sievers PSill MBlume CClear cell meningiomas are defined by a highly distinct DNA methylation profile and mutations in SMARCE1. Acta Neuropathol. 2021;141(2):281-290. doi:10.1007\/s00401-020-02247-2"},{"issue":"1","key":"bib7","series-title":"Neurosurgery","first-page":"218","article-title":"Intraspinal clear cell meningioma: diagnosis and management: report of two cases","volume":"48","author":"Jallo","year":"2001","unstructured":"Jallo GIKothbauer KFSilvera VMEpstein FJ.Intraspinal clear cell meningioma: diagnosis and management: report of two cases. 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