Primary intradural Hodgkin lymphoma of the conus medullaris and cauda equina: case report

Williamson, Timothy J; Wang, Michael T.; Clark, Jonathan; Williams, Julia; Drnda, A.

doi:10.2217/cns-2020-0002

Cited by 6 publications

(8 citation statements)

References 30 publications

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“…The vast majority of PDL cases are categorized as NHL, so clinical information is scarce regarding PDHL 10 . There have only been four published case studies of PDHL, 4‐7 three cases of extracranial PDHL, and one case of an intracranial PDHL, like in our patient (Table 1). To our knowledge, this is only the second reported case of intracranial PDHL, and it was successfully managed with subtotal resection, chemotherapy, and ISRT.…”

Section: Discussionmentioning

confidence: 80%

“…Our patient presented with slurred speech, memory loss, and lightheadedness, due to tumor mass effects, in contrast to published cases of PDHL that presented with neuromuscular weakness due to intradural spinal masses. [5][6][7] The patient was initially managed with dexamethasone, prior to neurosurgery which reduced the size of the tumor. The role of upfront and extensive surgery is not fully delineated in PDL.…”

Section: Discussionmentioning

confidence: 99%

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Isolated Hodgkin lymphoma of the intracranial dura: A case report and review of the literature

Kanagalingam

Velker

Pejhan

et al. 2023

Clinical Case Reports

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Isolated Hodgkin lymphoma of the intracranial dura: A case report and review of the literature

Kanagalingam

Velker

Pejhan

et al. 2023

Clinical Case Reports

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“…Three of the 16 patients received chemotherapy (cyclophosphamide, vincristine, procarbazine and prednisone or MTX) in addition to surgery and RT with no evidence of disease after a median follow up of 14 months. Favourable outcomes have also been described in more recent case reports of patients treated with similar strategies 26,27 …”

Section: Subtypes Of Rare Cns Lymphomamentioning

confidence: 79%

“…Favourable outcomes have also been described in more recent case reports of patients treated with similar strategies. 26,27 Reported treatment approaches for secondary CNS-HL are similar to those for primary CNS-HL, with a greater tendency to use chemotherapy (with or without RT). Immune checkpoint inhibitors, particularly programmed cell death protein 1 (PD-1) and programmed death-ligand 1 (PD-L1) inhibitors, have an established role in the clinical management of relapsed and refractory systemic HL, raising the possibility of their utility in CNS-HL.…”

Section: Hodgkin Lymphomamentioning

confidence: 99%

Rare central nervous system lymphomas

2022

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Central nervous system (CNS) lymphomas are rare malignancies characterised by lymphoid infiltration into the brain, spinal cord, cranial nerves, meninges and/or eyes in the presence or absence of previous or concurrent systemic disease. Most CNS lymphomas are of the diffuse large B‐cell lymphoma (DLBCL) subtype for which treatment strategies, particularly the use of high‐dose methotrexate‐based protocols and consolidation with autologous stem cell transplantation, are well established. Other histopathological subtypes of CNS lymphoma are comparatively less common with published data on these rare lymphomas dominated by smaller case series and retrospective reports. Consequently, there exists little clinical consensus on the optimal methods to diagnose and manage these clinically and biologically heterogeneous CNS lymphomas. In this review article, we focus on rarer CNS lymphomas, summarising the available clinical data on incidence, context, diagnostic features, reported management strategies, and clinical outcomes.

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“…For example, Williamson et al documented a case of spinal PCNSL impinging on the conus medullaris and cauda equina. 46 Because of their location, spinal PCNSLs are more likely to present clinically before they are detectable on imaging, with patients typical-ly presenting with radiculopathy and other critical signs, such as sphincter dysfunction. 47 Standard treatment of PCNSLs is multimodal, with well-established regimens including a combination of radiotherapy, chemotherapy, and immunotherapy.…”

Section: Primary Cns Lymphomamentioning

confidence: 99%

Immunotherapeutic treatments for spinal and peripheral nerve tumors: a primer

Bryant

Govindarajan

et al. 2022

Neurosurgical Focus

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OBJECTIVE Spinal and peripheral nerve tumors are a heterogeneous group of neoplasms that can be associated with significant morbidity and mortality despite the current standard of care. Immunotherapy is an emerging therapeutic option to improve the prognoses of these tumors. Therefore, the authors sought to present an updated and unifying review on the use of immunotherapy in treating tumors of the spinal cord and peripheral nerves, including a discussion on mechanism of action, drug delivery, current treatment techniques, and preclinical and clinical studies. METHODS Current data in the literature regarding immunotherapy were collated and summarized. Targeted tumors included primary and secondary spinal tumors, as well as peripheral nerve tumors. RESULTS Four primary modalities of immunotherapy (CAR T cell, monoclonal antibody, viral, and cytokine) have been reported to target spine and peripheral nerve tumors. Of the primary spinal tumors, spinal cord astrocytomas had the most preclinical evidence supporting immunotherapy success with CAR T-cell therapy targeting the H3K27M mutation, whereas spinal schwannomas and ependymomas had the most evidence reported for monoclonal antibody therapy preclinically. Of the secondary spinal tumors, primary CNS lymphomas demonstrated some clinical response to immunotherapy, whereas multiple myeloma and bone tumor experiences with immunotherapy were largely limited to concept only. Within peripheral nerve tumors, the use of immunotherapy to treat neurofibromas in the setting of syndromes has been suggested in theory, and possible immunotherapeutic targets have been identified in malignant peripheral nerve tumors. To date, there have been 2 clinical trials involving spine tumors and 2 clinical trials involving peripheral nerve tumors that have reported results, all of which are promising but require validation. CONCLUSIONS Immunotherapy to treat spinal and peripheral nerve tumors has become an emerging area of research and interest. A large amount of preclinical data supporting the translation of this therapy into practice, aimed at ameliorating the poor prognoses of specific tumors, have been reported. Future clinical studies for translation will focus on the optimal therapy type and administration route to best target these tumors, which often preclude total surgical resection given their proximity to the neural and vascular elements of the spine.

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Primary intradural Hodgkin lymphoma of the conus medullaris and cauda equina: case report

Cited by 6 publications

References 30 publications

Isolated Hodgkin lymphoma of the intracranial dura: A case report and review of the literature

Isolated Hodgkin lymphoma of the intracranial dura: A case report and review of the literature

Rare central nervous system lymphomas

Immunotherapeutic treatments for spinal and peripheral nerve tumors: a primer

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