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Primary dural lymphomas: Clinical presentation, management, and outcome
Philipp Karschnia1,2,3, Tracy T Batchelor1, Justin T Jordan1
1Division of Neuro-Oncology, Department of Neurology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts.
Cancer
|March 17, 2020
Summary
Primary dural lymphoma (PDL) is a rare central nervous system (CNS) cancer. Multimodality treatment, including surgery, offers an excellent prognosis for PDL patients, with aggressive resection potentially improving survival.
Area of Science:
- Neuro-oncology
- Pathology
- Radiology
Background:
- Primary dural lymphoma (PDL) is a rare form of primary central nervous system (CNS) lymphoma originating from the dura mater.
- Limited clinical experience exists for PDL, necessitating further investigation into its characteristics.
Purpose of the Study:
- To determine the relative incidence, clinical presentation, and outcomes of primary dural lymphoma (PDL).
Main Methods:
- Retrospective analysis of institutional databases from neuro-oncology divisions.
- Identification of patients with pathologically confirmed PDL and no systemic involvement.
- Recording of clinical data, diagnostic findings, treatments, and outcomes.
Main Results:
- PDL accounted for 6.3% of primary CNS lymphomas (20 of 316 patients).
- Common subtypes included diffuse large B-cell lymphoma and marginal zone lymphoma.
- Imaging revealed extra-axial masses mimicking meningioma; diagnosis required tissue analysis.
- Overall survival was not reached at 5 years, with tumor resection extent correlating with survival.
Conclusions:
- PDL is a rare CNS lymphoma often misdiagnosed as meningioma on imaging.
- Multimodality treatment, including aggressive surgery in select cases, leads to excellent outcomes.
