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Primary bone lymphoma: polyostotic disease presenting as a cauda equina syndrome
Leire Ortiz-Fernandez1, Belen Sainz-Berrio, Fernando Perez-Ruiz
1Rehabilitation Division, Cruces Hospital, Barakaldo, Spain. leireor@hotmail.com
Summary
This case study highlights a rare B-cell primary bone lymphoma affecting multiple vertebrae, leading to rapid cauda equina syndrome. Early symptoms of low-back pain responded temporarily to corticosteroids.
Area of Science:
- Oncology
- Neurology
- Orthopedics
Background:
- Primary bone lymphoma is a rare malignancy, typically affecting a single vertebra.
- B-cell lymphoma is an uncommon subtype of primary bone lymphoma.
- Cauda equina syndrome is a serious neurological condition often requiring urgent intervention.
Observation:
- A patient presented with subacute low-back pain, initially responsive to corticosteroid treatment.
- Magnetic resonance imaging revealed involvement of multiple vertebrae.
- The patient rapidly developed cauda equina syndrome.
Findings:
- The diagnosis was confirmed via open biopsy, identifying B-cell primary bone lymphoma.
- The case presented with multifocal vertebral involvement at onset, atypical for this condition.
- Radicular syndromes as an initial symptom of lymphoma are exceptionally rare, particularly for B-cell types.
Implications:
- This case underscores the importance of considering rare diagnoses in persistent or rapidly progressing back pain.
- Early recognition and biopsy are crucial for timely diagnosis and management of primary bone lymphoma.
- Multifocal vertebral involvement and neurological compromise highlight the aggressive potential of this rare malignancy.
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