A Rare Case of Spontaneous Remission and Relapse of a Primary Central Nervous System Lymphoma

Autor: João Fernandes, Rui Ramos, Marta Almeida, Rui M. Almeida
Rok vydání: 2018
Předmět:
Linfoma/quimioterapia
Pediatrics
medicine.medical_specialty
Neoplasias do Sistema Nervoso Central/quimioterapia
Linfoma/radioterapia
medicine.medical_treatment
lcsh:Medicine
Spontaneous remission
Central Nervous System Neoplasms/radiotherapy
Central Nervous System Neoplasms
Antineoplastic Combined Chemotherapy Protocols
Humans
Medicine
Lymphoma/drug therapy
lcsh:R5-920
Chemotherapy
medicine.diagnostic_test
Brain Neoplasms
business.industry
Brain biopsy
lcsh:R
Remission Induction
Primary central nervous system lymphoma
Brain
General Medicine
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Lymphoma/radiotherapy
Lymphoma
Neoplasm Regression
Spontaneous
Cytarabine
Central Nervous System Neoplasms/drug therapy
Neoplasias do Sistema Nervoso Central/radioterapia
Female
Methotrexate
Rituximab
Lymphoma
Large B-Cell
Diffuse
Neoplasm Recurrence
Local
lcsh:Medicine (General)
business
medicine.drug
Zdroj: Repositório Científico de Acesso Aberto de Portugal
Repositório Científico de Acesso Aberto de Portugal (RCAAP)
instacron:RCAAP
Acta Médica Portuguesa, Vol 31, Iss 12, Pp 777-783 (2018)
ISSN: 1646-0758
0870-399X
DOI: 10.20344/amp.10198
Popis: Primary central nervous system lymphoma remission after steroid treatment is a well-known phenomenon, but remission without any type of treatment is extremely rare. We present a rare case of spontaneous remission of a diffuse large B-cell lymphoma of the central nervous system as well as its subsequent reappearance in another location. The atypical presentation misled the neurosurgeons and neurologists, delaying diagnosis and treatment. The patient underwent brain biopsy after the relapse and started radiotherapy and chemotherapy with cytarabine + methotrexate + rituximab. As of 32 months after the diagnosis, the patient remained asymptomatic, with no focal neurological deficits and the disease in complete remission. A PubMed search of the literature up to June 2017 regarding spontaneous remission central nervous system lymphoma was also carried out.É bem conhecida a remissão com corticoterapia dos linfomas primários do sistema nervoso central, mas a sua remissão sem qualquer tipo de tratamento é extremamente rara. Apresentamos um caso raro de uma remissão espontânea e posterior recidiva noutra localização de um linfoma difuso de grandes células B do sistema nervoso central. A apresentação atípica deste caso confundiu os neurocirurgiões e neurologistas, atrasando o diagnóstico e tratamento. A doente foi submetida a biópsia de uma das lesões cerebrais e, posteriormente, iniciou radioterapia e quimioterapia com citarabina + metotrexato + rituximab. Neste momento, 32 meses após o diagnóstico histológico, a doente encontra-se assintomática, sem défices neurológicos focais e com remissão completa da doença. Foi também efetuada uma pesquisa na PubMed até junho de 2017 sobre a remissão espontânea dos linfomas do sistema nervoso central.
Databáze: OpenAIRE
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