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Primary cauda equina lymphoma treated with high-dose methotrexate
Motoyuki Iwasaki1, Kazutoshi Hida, Shunsuke Yano
1Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan. jzesso801@yahoo.co.jp
Neurologia Medico-Chirurgica
|September 26, 2012
Summary
A rare cauda equina lymphoma in a 69-year-old man caused progressive paraparesis. Treatment included high-dose methotrexate chemotherapy and irradiation, leading to complete remission but eventual death from pneumonia.
Area of Science:
- Neurology
- Oncology
- Pathology
Background:
- Primary central nervous system lymphoma (PCNSL) is rare.
- PCNSL originating in the cauda equina is exceptionally rare.
Observation:
- A 69-year-old man presented with progressive paraparesis.
- The patient had a lesion in the cauda equina.
Findings:
- Histological examination revealed large B-cell type lymphoma.
- The patient underwent biopsy, high-dose methotrexate chemotherapy (3.5 g/m(2)), and local irradiation.
- Magnetic resonance imaging showed complete remission of the lesion.
Implications:
- This case highlights an extremely rare presentation of PCNSL.
- The treatment strategy achieved complete remission but the patient's outcome was confounded by pneumonia.
- Further research is needed to establish optimal treatment protocols for cauda equina lymphoma.