Sciatic nerve neurolymphomatosis as the initial presentation of primary diffuse large B-cell lymphoma: a rare cause of leg weakness

Abstract

Neurolymphomatosis (NL), defined as lymphocytic invasion of the peripheral nervous system in a hematologic malignancy setting, is a rare form of lymphoma that may occur as an initial presentation or recurrence [1]. Involvement of the peripheral nerves, spinal nerve roots, nerve plexus, cranial nerves, and multiple sites has been reported [2]. Since its characteristic symptoms vary according to the site of involvement, physicians might fail to obtain an accurate diagnosis. NL should be discriminated from other neuro-

A case report of surgical management of a solitary Non-Hodgkin's Lymphoma (NHL) arising from the proximal sciatic nerve

“… Misdraji, et al, 2000 [ 5 ] F 62 Pain and sensory motor neuropathy for 5 months B cell diffuse NHL – Chemo radiotherapy Local residual disease 57 months after onset Misdraji, et al, 2000 [ 5 ] M 49 Pain and sensory motor neuropathy for 8 months DLBCL – Chemotherapy Died of CNS dissemination Quiñones-Hinojosa A, et al, 2000 [ 6 ] M 52 Pain and muscle weakness Burkit high grade B cell lymphoma Lesser trochanter to popliteal fossa Surgery followed by chemo radiotherapy Died in 1 year due to CNS dissemination. Kim KT, et al, 2021 [ 7 ] M 57 Pain and weakness DLBCL non germinal centre type Sciatic nerve at greater sciatic foramen involving L5 and S1 roots Chemo radiotherapy Slight improvement in weakness. No systemic involvement.…”

“…This is a very rare form of lymphoma that can occur as an initial presentation or recurrence. It affects various peripheral nerves and nerve roots, therefore may mimic disc-related nerve root pathology or compressive mononeuropathy and may result in a delay in the diagnosis and treatment [ 7 ]. However, based on the published case reports, the duration of symptoms does not seem to have an effect on the oncological outcome.…”

“…The site of the tumour in the sciatic nerve is at the mid or lower thigh in almost all the reported cases except one which had the lesion in the pelvis and the gluteal region involving the L5 and S1 nerve roots [ 7 ]. Similarly, this case also had the involvement of pelvic and gluteal segments of the sciatic nerve with S1 and S2 nerve root involvement.…”

“…The literature search was done in PubMed and Google Scholar using the medical search terms “sciatic nerve”, “Primary lymphomas”, “solitary”, and “Neurolymphomatosis”. Only 15 cases of solitary lymphomas of the sciatic nerve are published in the literature [ [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] ]. Here we report the youngest patient, with a more proximal sciatic nerve tumour with involvement of nerve roots who underwent successful surgical resection using a combined approach with satisfactory functional outcome.…”