[Primary malignant lymphoma of the skull presenting as a growing mass in the forehead; a case report]

A rare case of primary malignant lymphoma of the skull was reported. A 74-year-old woman was admitted to our hospital complaining of a growing mass in her forehead where she had had minor trauma one month previously. On admission, neurological findings were normal and an elastic hard tumor (6 x 6 x 2 cm) was found in the right frontal region. Computed tomography (CT) showed a large soft tissue mass in the subcutaneous tissue and a small mass in the ethmoid sinus, with erosion at the inner and outer tables of the frontal bone. Magnetic resonance imaging revealed a low intensity area in the bone marrow beneath the tumor. Right carotid angiography showed that the tumor was fed by branches of the ophthalmic artery in the arterial phase and stained in the capillary phase. Partial excision of the tumor was performed, but the affected bone was left because of her advanced age, even though thinning and spicular formation of the frontal bone were observed beneath the tumor in places. Pathological examination showed the tumor to be a malignant lymphoma of non-Hodgkin and diffuse mixed type. Postoperatively, systemic examinations were performed by 99mTechnetium-MDP bone scanning, 67Gallium citrate scanning, bone marrow puncture, and CT scanning, without any evidence of systemic lymphoma. The patient received postoperative chemotherapy with Cyclophosphamide, Doxorubicin HCl, Vindesine Sulfate, Prednisolone, and complete remission has been achieved for the 8 months since the operation.