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Spontaneous Regression Of Primary Malignant Intracranial Lymphoma

Sugita et al., 1988Lymphoma

Sugita, Y., Shigemori, M., Yuge, T., Iryo, O., Kuramoto, S., Nakamura, Y., & Morimatsu, M. (1988). spontaneous regression of primary malignant intracranial lymphoma. Surgical neurology, 30(2), 148–152. https://doi.org/10.1016/0090-3019(88)90102-4

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Abstract

A rare case of intracranial multiple tumor, which disappeared spontaneously on serial cranial computed tomography (CT) scans, is described. The initial CT scan showed multiple, well-enhanced lesions in the right frontal and parietal lobes. The lesions disappeared spontaneously without any treatment during the 2 following months of observation. One month later, however, a newly formed tumor was found on serial CT-scanning. Surgical intervention confirmed the histologic diagnosis of a non-Hodgkin's, large, and diffuse-type malignant lymphoma. The possible mechanism of temporal disappearance of tumors on CT scanning is discussed.

Case Details

Disease Location

Intracranial (right frontal and parietal lobes)

Personal Characteristics

63 -year-old female

Clinical Characteristics

Patient complained of progressive weakness of the left upper extremities and occasional convulsive seizures for 3 weeks she was admitted on august 30, 1985 neurological exam revealed an altered state and weakness of the left upper extremities without sensory disturbance analysis of csf indicated extremely high protein and slightly increased cells counts a CT demonstrated multiple mass lesions in the frontal and parietal lobes, which were well enhanced with a contrast medium MRI performed on september 12th demonstrated multiple mass lesions in the frontal and parietal lobes after being discharged, she returned on dec 13th with a newly formed tumor in the right occipital lobe on CT she underwent exploratory craniotomy on january 24th, 1986 a gray, soft, well-circumscribed mass 3x3x3cm in size was found in the subcortical region of the right occipital lobe. Total removal of the tumor was performed. Pathologic exam confirmed diagnosis of malignant lymphoma (non-hodgkin, large, diffuse type) postop course was uneventful and she received radiation therapy (5000 rads, linear accelerator, whole brain) and chemo with dexamethasone

Remission Characteristics

From the time of admission and the CT on september 24th, neurological status gradually improved and the size of the mass lesions had markedly decreased MRI on nov 18th showed disappearance of the mass lesions, she was discharged and followed up as an outpatient she was discharged without any neurological deficits on april 6th, 1986

Treatment & Mechanisms

Proposed Remission Mechanisms

The altered immunologic competence of the host may have temporarily reduced the size of the lymphoma tissue

Clinical Treatment

Excision of the right occipital tumor postop radiation therapy (5000 rads, linear accelerator, whole brain) and chemo with dexamethasone

Non-Clinical Treatment

None reported