Primary meningeal Burkitt-type lymphoma presenting as the first clinical manifestation of acquired immunodeficiency syndrome

Abstract

The purpose of this study is to report a rare case of primary meningeal high grade Burkitt-type lymphoma presenting as the first clinical manifestation of acquired immunodeficiency syndrome. A 38-year-old Caucasian man, with a negative past medical history, sought treatment after experiencing global headache for five days. CT-Scan revealed a right front-temporo-parietal hyperdense subdural expansive mass. A craniotomy was performed and a hard white subdural was microsurgically dissected. Some hours after the surgery, the patient developed hemispheric cerebral edema and intracranial hypertension syndrome. Decompressive craniotomy was performed and the patient had an excellent recovery. Screening blood tests diagnosed human immunodeficiency virus infection. Further investigation ruled out systemic diseases. Eleven days after the initial surgery, the patient developed an acute respiratory failure and sepsis, dying on that day. Pathological studies diagnosed Burkitt-type lymphoma.

Primary Central Nervous System Burkitt Lymphoma, Presenting with Long-Term Fluctuating Level of Consciousness: A Case Report and Literature Review on Challenges in Diagnosis and Management

“…Burkett lymphoma is a very aggressive subtype of NHL which rarely presents as a primary central nervous system disease and is usually associated with a poor outcome [ 34 ]. Initial symptoms and clinical signs of PCNSBL are sometimes difficult to recognize, and can be associated with long-term and fluctuating symptoms as seen in this case, hindering early diagnosis and treatment [ 34 ].…”

“…Burkett lymphoma is a very aggressive subtype of NHL which rarely presents as a primary central nervous system disease and is usually associated with a poor outcome [ 34 ]. Initial symptoms and clinical signs of PCNSBL are sometimes difficult to recognize, and can be associated with long-term and fluctuating symptoms as seen in this case, hindering early diagnosis and treatment [ 34 ]. And since only a limited number of cases are reported in the literature, not enough information is available regarding different clinical presentations, diagnosis, and treatment modalities.…”

“…Over the past years, only a few cases of Burkitt lymphoma were reported as a primary disease affecting the CNS in both adults and children [ 6 – 33 ]. Unfortunately, there is a challenge in early recognition and diagnosis of such type of brain lymphoma, resulting in a delay in treatment and therefore, a poor prognosis [ 34 ]. Furthermore, there is no specific treatment protocol for primary CNS Burkitt lymphoma, which adds to the difficulty in managing those patients [ 35 ].…”

Primary CNS Burkitt Lymphoma: A Case Report of a 55-Year-Old Cerebral Palsy Patient

“…The concept of complete surgical resection has fallen under scrutiny in recent years as well. Previously, many subscribed to complete resection of the mass with recent reports challenging this citing an increase in postoperative neurological deficits with no OS benefit [ 2 , 3 , 15 ]. Currently, the decision for excision when CNS lesions are the only areas of disease is made on a case by case basis with regard to tumor location and expected postsurgical deficits.…”