Persistent hiccups and Horner’s syndrome in a case of primary CNS lymphoma with diffuse cerebral, hypothalamic and lateral brainstem involvement – An exercise in clinical neuroanatomy

Kim, Boaz; Banh, Lisa; McNeill, Peter; Macfarlane, Adam; McKelvie, Penny; Thien, Christopher; Han, Tiew F.

doi:10.1016/j.jocn.2020.09.061

Cited by 4 publications

(5 citation statements)

References 12 publications

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“…PBSL mainly affected adults in their sixth decade with a slight male predominance. Parallel to previous case reports [6][7][8][9][10][11][12][13][14][15][16][17][18], our study con rmed that all PBSLs were NHLs. The prognosis of PBSL is poor.…”

Section: Clinical Features Survival and Prognostic Factors Of Pbslsupporting

confidence: 88%

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Primary Brainstem Lymphoma: A Population-Based Study

Chen

Bo²,

Hu³

et al. 2021

Preprint

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Purpose. Primary brainstem lymphoma (PBSL) is rare and malignant. Understanding of this disease is lacking. We aimed to characterize clinical features, estimate survival and explore survival-related factors of PBSL.Methods. Patients with a histological diagnosis of primary lymphoma in the brainstem (C71.7) from 1975 to 2016 were retrieved from Surveillance, Epidemiology, and End Results (SEER) program. Log-rank tests, univariate and multivariate Cox proportional hazard analyses were used to identify survival-related factors. Results. PBSL constituted 2.7% of brainstem malignancies. The median age of the PBSL patients were 59.5 years. Diffuse large B cell lymphoma (n = 49, 84.5%) was the most prevalent histology among the 58 cases with reported specific lymphoma subtype. The majority of PBSLs were localized (n = 46, 52.3%), at low Ann Arbor Stage (I/II, n = 63, 70.5%), and presented as a single primary (n = 71, 80.7%). Chemotherapy was applied in 50 (56.8%) cases. Three-year overall survival (OS) and disease-specific survival (DSS) rates were 42.7% and 53.5%, respectively. Multivariate analyses showed that independent predictive/prognostic factors for OS were age (P = 0.004), tumor number (P = 0.029), and chemotherapy (P = 0.001); DSS-related factors only included age (P = 0.014) and chemotherapy (P = 0.008). Conclusions. We estimated survival rates for PBSL patients. Factors associated with OS and DSS were also identified. Our findings addressed the importance of chemotherapy in treating PBSL patients.

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Section: Clinical Features Survival and Prognostic Factors Of Pbslsupporting

confidence: 88%

“…But PCNSL located at the brainstem predicts more severe surgical complications [5]. At present, there are only several case reports from a single institute [6][7][8][9][10][11][12][13][14][15][16][17][18]. The existing published studies failed to estimate the survival of PBSL, let alone to explore survival-related factors.…”

Section: Introductionmentioning

confidence: 99%

Primary Brainstem Lymphoma: A Population-Based Study

Chen

Bo²,

Hu³

et al. 2021

Preprint

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“…Anorexia due to brain tumors has already been reported, and in most cases, those tumors are located in the hypothalamus. 1,7) There are also a few case reports of anorexia caused by tumors in the medulla oblongata such as glioblastoma 8) and germinoma, 9) and in the latter case, as in ours, the patient's appetite was restored after treatment (Table 1). Generally, the reported symptoms of medulla oblongata tumors are as follows: headache, nausea/vomiting, gait disturbance, nystagmus, lower cranial nerve palsy, and dysesthesia.…”

Section: Discussionsupporting

confidence: 64%

Biopsy-proven Primary CNS Lymphoma in the Medulla Oblongata Presenting as Anorexia

Kawajiri

Takeuchi

TAKAHASHI

et al. 2023

NMC Case Report Journal

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Eating disorders caused by brain tumors are infrequently seen. Recent studies revealed that a neurocircuit from the nucleus tractus solitarius of the medulla oblongata to the hypothalamus participates in the control of appetite. Among brain tumors, those located in the brain stem, especially a solitary one in the medulla oblongata, are rare. Tumors in the brainstem are generally considered gliomas, and with the difficulty in reaching the lesion, treatment without histological confirmation is often performed. However, there are a few reported cases of medulla oblongata tumors other than gliomas. We describe a case of a 56-year-old man who presented with persistent anorexia. Magnetic resonance images revealed a solitary tumor in the medulla oblongata. After several examinations, craniotomy for the biopsy of the tumor using the cerebellomedullary fissure approach was carried out and primary central nervous system lymphoma (PCNSL) was histologically proven. The patient was treated with effective adjuvant therapy and was discharged home after he recovered from the symptoms. No tumor recurrence was recognized 24 months after surgery. A PCNSL arising only from the medulla oblongata is very rare, and anorexia can be an initial symptom of a tumor in the medulla oblongata. Surgical intervention is safely achieved and is a key to a better clinical outcome.

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“…PBSL mainly affected adults in their sixth decade with a slight male predominance. Parallel to previous case reports (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18), our study confirmed that all PBSLs were NHLs. The prognosis of PBSL is poor.…”

Section: Clinical Features Survival and Prognostic Factors Of Pbslsupporting

confidence: 89%

“…However, PCNSL located at the brainstem predicts more severe surgical complications (5). At present, there are only several case reports from a single institute (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). The existing published studies failed to estimate the survival of PBSL, let alone explore survival-related factors.…”

Section: Introductionmentioning

confidence: 99%

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Persistent hiccups and Horner’s syndrome in a case of primary CNS lymphoma with diffuse cerebral, hypothalamic and lateral brainstem involvement – An exercise in clinical neuroanatomy

Cited by 4 publications

References 12 publications

Primary Brainstem Lymphoma: A Population-Based Study

Primary Brainstem Lymphoma: A Population-Based Study

Biopsy-proven Primary CNS Lymphoma in the Medulla Oblongata Presenting as Anorexia

Table_1_v1.docx

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