Cauda equina syndrome in a patient with human immunodeficiency virus and secondary central nervous system lymphoma: a case report.
Cauda equina syndrome
HIV
Immunocompromised
Lymphoma
Journal
Journal of medical case reports
ISSN: 1752-1947
Titre abrégé: J Med Case Rep
Pays: England
ID NLM: 101293382
Informations de publication
Date de publication:
15 Nov 2023
15 Nov 2023
Historique:
received:
27
07
2023
accepted:
12
10
2023
medline:
16
11
2023
pubmed:
15
11
2023
entrez:
15
11
2023
Statut:
epublish
Résumé
Secondary central nervous system lymphoma (SCNSL) is a known complication of immunocompromised patients with most cases involving the brain parenchyma. Reports of cauda equina syndrome (CES) caused by SCNSL are exceedingly scarce as involvement of this anatomical region is extremely uncommon. We report a case of a 46-years-old, African, female patient with human immunodeficiency virus (HIV) who developed CES in the context of SCNSL. There were no blasts present in the peripheral blood smear. We provide a review of the literature, discussion of the clinical evolution of this patient and the radiological/histopathological findings. The patient ultimately responded well to induction chemotherapy and high dose methotrexate. This case report demonstrates that CES, while a rare occurrence in this clinical context, should be considered in at-risk patients especially those presenting with abnormal neurological findings. Prompt recognition may prevent permanent neurological injury and obviate the need for more invasive therapeutic interventions.
Sections du résumé
BACKGROUND
BACKGROUND
Secondary central nervous system lymphoma (SCNSL) is a known complication of immunocompromised patients with most cases involving the brain parenchyma. Reports of cauda equina syndrome (CES) caused by SCNSL are exceedingly scarce as involvement of this anatomical region is extremely uncommon.
CASE PRESENTATION
METHODS
We report a case of a 46-years-old, African, female patient with human immunodeficiency virus (HIV) who developed CES in the context of SCNSL. There were no blasts present in the peripheral blood smear. We provide a review of the literature, discussion of the clinical evolution of this patient and the radiological/histopathological findings. The patient ultimately responded well to induction chemotherapy and high dose methotrexate.
CONCLUSION
CONCLUSIONS
This case report demonstrates that CES, while a rare occurrence in this clinical context, should be considered in at-risk patients especially those presenting with abnormal neurological findings. Prompt recognition may prevent permanent neurological injury and obviate the need for more invasive therapeutic interventions.
Identifiants
pubmed: 37964357
doi: 10.1186/s13256-023-04212-5
pii: 10.1186/s13256-023-04212-5
pmc: PMC10647035
doi:
Types de publication
Review
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
476Informations de copyright
© 2023. The Author(s).
Références
Neuro Oncol. 2018 Apr 9;20(5):687-694
pubmed: 29036697
Q J Med. 1986 Jul;60(231):699-714
pubmed: 3763820
J Natl Cancer Inst. 2018 Jun 1;110(6):598-607
pubmed: 29267895
Handb Clin Neurol. 2018;152:177-186
pubmed: 29604975
Haematologica. 2013 May;98(5):808-13
pubmed: 23144196
Br J Haematol. 2014 Aug;166(3):311-25
pubmed: 24837460
J Exp Med. 1986 Dec 1;164(6):2049-60
pubmed: 3491176
Lancet. 1991 Oct 19;338(8773):969-73
pubmed: 1681341
J Clin Oncol. 2006 Mar 10;24(8):1281-8
pubmed: 16525183
Semin Oncol. 1998 Aug;25(4):492-502
pubmed: 9728599
Curr Opin Oncol. 1994 Sep;6(5):489-91
pubmed: 7827151
Neurology. 2017 Aug 22;89(8):796-804
pubmed: 28747447
J Acquir Immune Defic Syndr. 2010 Apr;53(5):656-60
pubmed: 20160652