Primary Spinal Epidural Lymphoma As a Cause of Spontaneous Spinal Anterior Syndrome: A Case Report and Literature Review

Córdoba-Mosqueda, María Elena; Guerra-Mora, José Raúl; Silva, Martha Cristina Sánchez; Vicuña-González, Rosa María; Torre, Abraham Ibarra–de la

doi:10.1055/s-0036-1597692

Cited by 7 publications

(5 citation statements)

References 10 publications

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“…The 21 selected studies 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 that met the eligibility criteria are described in Table 1 , reporting a total of 25 cases (20 male and 5 female patients), in the age range of 15 to 79 years (average: 52.72 years). Only 10 cases reported follow-up as 4 patients were lost to follow-up and 11 studies did not report it.…”

Section: Resultsmentioning

confidence: 99%

B-Cell Lymphoma Intramedullary Tumor: Case Report and Systematic Review

Gonsalves¹,

Raffa²,

Sousa

et al. 2023

Asian J Neurosurg

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Intramedullary tumors represent the major cause of spinal cord injuries, and its symptoms include pain and weakness. Progressive weakness may concomitantly occur in the upper and lower limbs, along with lack of balance, spine tenderness, sensory loss, trophic changes of extremity, hyperreflexia, and clonus. The study protocol was in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A systematic search of the MEDLINE electronic database was performed to identify the studies reporting the clinical features of children and adults who presented with an intramedullary lymphoma. Twenty-one studies were included, reporting 25 cases. Manuscripts were excluded if the full-text article was not available, original data were not reported (e.g., review articles), or if the main disease was not intramedullary lymphoma. A structured data extraction form was employed to standardize the identification and retrieval of data from manuscripts. To enlighten the discussion, a case is also presented. An 82-year-old woman with Fitzpatrick skin type II, diagnosed and treated for non-Hodgkin's lymphoma 7 years ago, was admitted with mental confusion and memory loss for the past 2 months—evolving with recurring falls from her own height. One day before admission, she displayed Brown-Séquard syndrome. An expansive lesion from C2 to C4 in the cervical spinal cord was found and a hypersignal spinal cord adjacent was described at the bulb medullary transition to the C6–C7 level. A primary spinal cord tumor was considered, as well as a melanoma metastasis, due to the lesion's flame pattern. The patient presented a partial recovery of symptoms and a reduction of the spinal cord edema after being empirically treated with corticosteroids, but the lesion maintained its extent. Subsequently, a large diffuse B-cell lymphoma with nongerminal center was found in open body biopsy, infiltrating neural tissue. The main objective of the present study is to report a surgical case treated for a large diffuse B-cell lymphoma, in addition to presenting the results of a systematic review of primary intramedullary spinal cord lymphoma.

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Section: Resultsmentioning

confidence: 99%

B-Cell Lymphoma Intramedullary Tumor: Case Report and Systematic Review

Gonsalves¹,

Raffa²,

Sousa

et al. 2023

Asian J Neurosurg

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“…Anterior or posterior spinal stabilisation maybe required if there was spinal instability 10. However, combined modality treatment, including surgery, RT or CTh, is the strategy recommended by most authors 11 12. In order to release spinal cord compression promptly, RT needs to be used first, followed by CTh.…”

Section: Discussionmentioning

confidence: 99%

“…Although there is lack of evidence in the literature regarding the best CTh scheme, most authors recommend the combination of R-CHOP or MR-CHOP in association with RT 11 12 14 17…”

Section: Discussionmentioning

confidence: 99%

Primary spinal epidural lymphoma: a rare entity with an ambiguous management

et al. 2020

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Lymphomas are malignant lymphoid tumours arising from lymphocytic cells. They usually develop in the lymphoid tissues and can spread to other organs; however, primary extra-nodal locations such as the spinal epidural space are less common. The authors report the case of a primary diffuse large B-cell lymphoma of the thoracic spine in a 65-year-old man, who presented to the emergency department with signs of upper motor neuron lesion. The patient underwent surgery in order to decompress the spinal cord. The treatment was concluded with six cycles of chemotherapy with methotrexate, rituximab, cyclophosphamide, vincristine and prednisone followed by radiotherapy. At the 24-month follow-up, no signs of epidural lesion or bone contrast enhancement were observed in thoracic spine MRI. Surgical decompression is recommended in patients with signs of spinal cord injury in order to prevent irreversible neurological damage and is related to high rates of disease-free survival.

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“…Extranodal non-Hodgkin's lymphoma (NHL) accounts for 24–48% of all NHL, while primary spinal epidural lymphoma comprises 0.9% of all extranodal NHLS [ 2 ]. Spinal cord compression is an uncommon primary manifestation and requires to be treated with surgery for the purpose of diagnosis and decompression [ 3 ]. The diagnosis is challenging due to its atypical clinical presentation and the difficulty in establishing a conclusive tissue diagnosis with MRI and core biopsy [ 4 ].…”

Section: Introductionmentioning

confidence: 99%