Open AccessPrimary CNS Lymphoma Arising from the 4th Ventricle: A Case Report and Review of the Literature
Author(s) -
Ava Brozovich,
Donald C. Ewing,
Ethan Burns,
Courtney Hatcher,
Gonzalo Acosta,
Usman Khan,
Betty Chung,
Leena Samuel,
Jasleen K. Randhawa,
Sai Ravi Pingali
Publication year - 2019
Publication title -
case reports in oncological medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.173
H-Index - 7
eISSN - 2090-6714
pISSN - 2090-6706
DOI - 10.1155/2019/2671794
Subject(s) - medicine , fourth ventricle , lymphoma , diffuse large b cell lymphoma , nausea , differential diagnosis , vomiting , radiology , magnetic resonance imaging , pathology
A 65-year-old male with a history of ischemic strokes, seizures, and subarachnoid hemorrhage presented with a 4-week history of progressive diplopia, vertigo, nausea, and vomiting. Magnetic resonance imaging (MRI) revealed a 2.5 × 1.8 × 1.7 cm posterior fossa mass arising from the roof of the 4 th ventricle extending into the cerebellar vermis. Posterior fossa craniotomy with stereotactic biopsy confirmed a locally invasive diffuse large B-cell lymphoma (DLBCL). Primary central nervous system lymphoma (PCNSL) arising from the 4 th ventricle is a rare extranodal manifestation of non-Hodgkin lymphoma (NHL), with few cases documented in the literature. Review of available cases lends support that lymphoma arising from the 4 th ventricle has a variable clinical presentation, occurs most commonly in immunocompetent males, and should be on the differential of any immunocompetent adult presenting with a posterior fossa mass. Optimal treatment modalities are based largely on phase 2 clinical trials, and recommended guidelines regardless of anatomic location should be adhered to.