Unusual relapse of primary central nervous system lymphoma both inside and outside central nervous system in a patient with ventriculoperitoneal shunt: a case report.

Unusual relapse of primary central nervous system lymphoma both inside and outside central nervous system in a patient with ventriculoperitoneal shunt: a case report.

World Neurosurg. 2019 Feb 19;:

Authors: Chen F, Guo H, Mao C, Jiang X, Liu S, Huang L, Wei X, Liang Z, Zhou D, Li W

Abstract
BACKGROUND: Relapse of primary central nervous system lymphoma (PCNSL) occurs primarily at the initial site, relapse outside central nervous system is very rare.
CASE DESCRIPTION: We present the case of a 62-year-old immuno-competent man who underwent a stereotactic biopsy to diagnose PCNSL and subsequent placement of ventriculoperitoneal shunt for symptom relief in November 2012. He got complete remission after 6 cycles of high dose methotrexate-based chemotherapy. In August 2017, relapse of lymphoma occurred in the abdomen, left basal ganglia and bilateral ventricle with the largest lesion being around the ventriculoperitoneal shunt in the abdomen. He got complete remission after 6 cycles of R-CHOP (rituximab, cyclophosphamide, epirubicin, vincristine and prednisolone) plus 8 cycles of high dose methotrexate chemotherapy.
CONCLUSION: Here we report the first case of extra-central nervous system relapse of PCNSL around the site of ventriculoperitoneal shunt in the abdomen after intensive chemotherapy. Neurosurgeons should be aware of a potential risk of PCNSL spread along the VPS.

PMID: 30794971 [PubMed - as supplied by publisher]

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