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Diffuse large B-cell lymphoma in the sphenoid sinus: A case report and review of literature
Daisuke Wajima1, Fumihiko Nishimura1, Katsuya Masui1
1Department of Neurosurgery, Nara Medical University, Shijo-Cho, Kashihara, Nara, Japan.
Background:
Non-Hodgkin lymphomas (NHLs) in paranasal sinus are uncommon, accounting for 0.17-2% of all NHL cases; it is especially rare in the sphenoid sinus. In this report, we describe a case of NHL in the sphenoid sinus.
Case Description:
A 66-year-old man presented with a sudden left eye movement disorder. His head computed tomography and gadolinium-enhanced magnetic resonance imaging (Gd-MRI) showed a mass lesion extending around the left sphenoid sinus. However, the tumor regrowth about twice was observed during 2 weeks, partial removal of tumor was performed by the endoscopic trans-nasal transsphenoidal surgery, then histologically proved it to be diffuse large B-cell lymphoma (DLBCL). After R-THP-COP regimen (rituximab 375 mg/m2,cyclophosphamide 750 mg/m2, epirubicin 50 mg/m2, vincristine 2 mg/day, and prednisolone 100 mg/day) and two courses of intrathecal methotrexate therapy for DLBCL, the symptoms and the lesion of enhanced Gd-MRI and fluorodeoxyglucose-positron emission tomography were completely disappeared.
Conclusion:
NHLs in the sphenoid sinus is very rare disease, however, it is important to be diagnosed pathologically as soon as possible for being in remission state by the chemotherapy.

