Diagnosis and treatment of primary central nervous system lymphoma with the primary lesion in the hypothalamus: a case report.
Adrenal Cortex Hormones
/ deficiency
Antimetabolites, Antineoplastic
/ therapeutic use
Central Nervous System Neoplasms
/ diagnosis
Chemoradiotherapy
Combined Modality Therapy
Endocrine System Diseases
/ etiology
Hormone Replacement Therapy
Humans
Hypopituitarism
/ etiology
Hypothalamic Neoplasms
/ diagnosis
Lymphoma, Large B-Cell, Diffuse
/ diagnosis
Magnetic Resonance Imaging
Male
Methotrexate
/ therapeutic use
Middle Aged
Treatment Outcome
Case report
Hypopituitarism
Hypothalamus
PCNSL
Journal
BMC endocrine disorders
ISSN: 1472-6823
Titre abrégé: BMC Endocr Disord
Pays: England
ID NLM: 101088676
Informations de publication
Date de publication:
11 Jan 2021
11 Jan 2021
Historique:
received:
11
07
2020
accepted:
26
12
2020
entrez:
12
1
2021
pubmed:
13
1
2021
medline:
3
9
2021
Statut:
epublish
Résumé
Primary central nervous system lymphoma is a rare extra-nodal lymphoma of the central nervous system. Primary central nervous system lymphoma lesions usually appear in the vicinity of the ventricle, and there are few reports of primary central nervous system lymphoma with hypothalamic-pituitary lesions. We treated a 56-year-old male with primary central nervous system lymphoma with the primary lesion in the hypothalamus, which was found by magnetic resonance imaging after sudden onset of endocrinological abnormalities. Initially, he was hospitalized to our department for hyponatremia. Endocrinological examination in conjunction with head magnetic resonance imaging and endoscopic biopsy revealed hypothalamic hypopituitarism and tertiary hypoadrenocorticism caused by a rapidly growing, diffuse large B-cell lymphoma in the hypothalamus. Remission of the tumor was achieved by high-dose methotrexate with whole brain radiotherapy, and some of the hormone responses were normalized. While primary central nervous system lymphoma is rare, it is important to note that hypopituitarism can result and that the endocrinological abnormalities can be partially restored by its remission.
Sections du résumé
BACKGROUND
BACKGROUND
Primary central nervous system lymphoma is a rare extra-nodal lymphoma of the central nervous system. Primary central nervous system lymphoma lesions usually appear in the vicinity of the ventricle, and there are few reports of primary central nervous system lymphoma with hypothalamic-pituitary lesions.
CASE PRESENTATION
METHODS
We treated a 56-year-old male with primary central nervous system lymphoma with the primary lesion in the hypothalamus, which was found by magnetic resonance imaging after sudden onset of endocrinological abnormalities. Initially, he was hospitalized to our department for hyponatremia. Endocrinological examination in conjunction with head magnetic resonance imaging and endoscopic biopsy revealed hypothalamic hypopituitarism and tertiary hypoadrenocorticism caused by a rapidly growing, diffuse large B-cell lymphoma in the hypothalamus. Remission of the tumor was achieved by high-dose methotrexate with whole brain radiotherapy, and some of the hormone responses were normalized.
CONCLUSIONS
CONCLUSIONS
While primary central nervous system lymphoma is rare, it is important to note that hypopituitarism can result and that the endocrinological abnormalities can be partially restored by its remission.
Identifiants
pubmed: 33430828
doi: 10.1186/s12902-020-00675-5
pii: 10.1186/s12902-020-00675-5
pmc: PMC7802214
doi:
Substances chimiques
Adrenal Cortex Hormones
0
Antimetabolites, Antineoplastic
0
Methotrexate
YL5FZ2Y5U1
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
13Subventions
Organisme : Japan Society for the Promotion of Science
ID : 17K09825
Organisme : Japan Society for the Promotion of Science
ID : 17K00850
Organisme : Japan Society for the Promotion of Science
ID : 18H02779
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