Primary Hodgkin’s Disease of the Bone Presenting with an Extradural Tumor

Moridaira, Kazuaki; Handa, Hiroshi; Murakami, Hirokazu; Uchiyama, Toshimasa; Takeuchi, Tokio; Sato, Sadao; Tamura, Jun’ichi; Naruse, Takuji; Tsuchiya, Jun

doi:10.1159/000204207

Cited by 15 publications

(4 citation statements)

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“…Malignant lymphoma spreads from the lymph node through the intervertebral foramina or may reach the epidural space from the vertebral body. 5,6,8,[16][17][18] In contrast to carcinoma with epidural metastasis, in spinal presentation of ML months may pass before the development of the first local pain or spinal cord compression and consequent paraparesis. 5 In one of our patients with an affected thoracic vertebra, the disease was discovered before any symptoms developed and remission was achieved with RT and KT.…”

Section: Discussionmentioning

confidence: 99%

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Epidural malignant lymphomas of the spine: collected experiences with epidural malignant lymphomas of the spinal canal and their treatment

et al. 2007

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Subjects and methods: The epidural presentation in eight patients was heralded by motor signs (paraparesis and plegia), in one by a lesion of the posterior columns of the spinal cord (ataxia), and in three by pain. One patient was free of complaints and symptoms. The affected epidural area was diagnosed previously by myelography and computerized tomography (CT), and later by magnetic resonance (MR), over the course of which the location was verified as thoracic in eight patients, cervical in one, and lumbar in four. The authors recommended surgical intervention in 9 out of 13 cases, in seven cases of Hodgkin's and six cases of non-Hodgkin's lymphoma. Seven patients were treated for recognized manifestations of malignant lymphoma while six were diagnosed by intraoperativehistological examination. Results and conclusion: The decompression operations for tumors resulted in limited improvement in seven patients (reduction in pain and return of ability to walk). Four patients were not operated on, two of which had significant improvement in their neurological symptoms. Paraparesis remained unchanged in one patient. One patient remained symptom-free. The authors emphasize the importance of interdisciplinary consultation and weighing individual priorities in the indications for operation on epidural ML.

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Section: Discussionmentioning

confidence: 99%

“…The rate of epidural occurrence in all case of MLs is rare (0.8-2.8%). [3][4][5][6][7][8][9][10] Due to this rate of occurrence small case number studies and case reports dominate the literature. Surgical intervention is recommended for epidural ML when myelocompression is found.…”

Section: Introductionmentioning

confidence: 99%

Epidural malignant lymphomas of the spine: collected experiences with epidural malignant lymphomas of the spinal canal and their treatment

et al. 2007

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“…Las complicaciones neurológicas que pueden acompañar a la enfermedad de Hodgkin son poco frecuentes. De entre ellas la compresión medular, por invasión del espacio epidural a partir de adenopatías de la región lumbar, es una situación poco común, algo más frecuente en linfomas no Hodgkin sobre todo de alto grado, y como presentación inicial es rara (1)(2)(3)(4). Los linfomas se presentan clínicamente como tumores extramedulares, principalmente de situación extradural, provocando un síndrome compresivo que afecta primero a las raíces y luego a la médula.…”

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Debut de linfoma Hodgkin con clínica de compresión medular

Calzada

Muñóz

Canales

et al. 2006

An. Med. Interna (Madrid)

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“…Various causes, such as Epstein-Barr virus infection, genetic errors and immunologic abnormalities have been proposed, but to date there is no evidence to support any of these explanations and the disease is postulated to be a neoplasm of unknown cause [7]. Primary bone lesions in patients with Hodgkin's disease are considered very rare and most reports are those of a small number of patients [7][8][9][10][11][12][13][14][15]. Of some interest is the finding of CD15 and CD30 in the bone lesions upon immunohistological staining, but no evidence is presented to suggest a genetic error or familial transmission of the disorder [7].…”

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Lymphoma of bone: a review of 140 patients

Mankin

Hornicek²,

Harmon³

et al. 2006

Therapy

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Background: Hodgkin's and non-Hodgkin's lymphoma commonly occur in patients in their middle years and are more frequent in males than in females. The cause of these entities is unknown, although infectious, immunologic and genetic origins have been postulated. Both diseases, and in particular, Hodgkin's lymphoma, are rarely seen in the skeletal system and are generally thought to have a better prognosis when confined to bone. Methods: The authors have treated 140 patients with Hodgkin's lymphoma (ten patients) and non-Hodgkin's lymphoma (130 patients) since 1972 and report the results in this presentation. More males were affected than females and the mean age of the study group was 45 years. The majority of these patients were MusculoSkeletal Tumor Society (MSTS) Stage II and Ann Arbor Stage I E . The principal sites of tumor occurrence were the femur, pelvis, tibia, humerus, spine and shoulder. Most often, treatment consisted of intralesional surgery followed by radiation and chemotherapy and only 12 of the 140 patients had marginal or wide resective surgery. Results: Overall survival for the patients was 68% in the non-Hodgkin's group (130 patients), but only 50% for those with Hodgkin's disease (ten patients). In addition, MSTS Stage, date of presentation and anatomic site had a significant effect on survival. Conclusions: Lymphoma principally occurring in bone is a difficult problem, partly because there is a high degree of variation in the presentation and treatment protocols are highly variable and sometimes not effective.

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Primary Hodgkin’s Disease of the Bone Presenting with an Extradural Tumor

Abstract: We report a very rare case of primary Hodgkin’s disease of the bone in a 56-year-old male. It presented with sudden onset of paraparesis which suggested an extradural tumor. Early appropriate therapy for similar patients with Hodgkin’s disease can improve their prognosis.

Cited by 15 publications

References 1 publication

Epidural malignant lymphomas of the spine: collected experiences with epidural malignant lymphomas of the spinal canal and their treatment

Epidural malignant lymphomas of the spine: collected experiences with epidural malignant lymphomas of the spinal canal and their treatment

Debut de linfoma Hodgkin con clínica de compresión medular

Lymphoma of bone: a review of 140 patients

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