Primary Malignant Lymphoma of the Cavernous Sinus. Case Report.

Abstract

A 59-year-old female presented with a very rare case of primary malignant lymphoma of the cavernous sinus manifesting as diplopia and right facial hypesthesia. Magnetic resonance (MR) imaging showed the tumor located in the right cavernous sinus as low intensity with marked enhancement by gadolinium. The tumor was partially removed by the transzygomatic extradural approach. The histological diagnosis was malignant lymphoma. Chest and abdominal computed tomography and gallium-67 scintigraphy revealed no other lesions in the body. The patient received conventional radiotherapy and her diplopia and right facial hypesthesia gradually improved. At 1 month after radiotherapy, MR imaging showed no evidence of residual tumor. Primary cavernous sinus malignant lymphoma is extremely rare, but should be considered in the differential diagnosis of cavernous sinus lesions. Histological confirmation of tumors in this region is essential for choosing the most appropriate treatment to achieve a better outcome.

Cavernous Sinus Syndrome as the Presentation of Systemic Non-Hodgkin’s Lymphoma

“…NHL treatment include aggressive chemotherapy and radiotherapy as the clinical characteristics are rapid growth and poor prognosis [12].…”

Orbital and Cavernous Sinus Lymphoma Masquerading as Post-Herpetic Neuralgia

“…2 When lymphomas do occur in the cavernous sinus, presenting symptoms usually include headache, ptosis, and diplopia. 1,2,[4][5][6][7][8] No cases to our knowledge have described a primary lymphoma of the cavernous sinus presenting as post-herpetic neuralgia.…”

“…Most lymphomas in this region are metastases from another location or direct extension of nasopharyngeal tumours. [1][2][3] To our knowledge, no cases have been reported in which post-herpetic neuralgia was the presenting symptom of primary lymphoma in the cavernous sinus.…”

Linfoma não-Hodgkin bilateral do seio cavernoso como manifestação inicial da síndrome de imunodeficiência adquirida: relato de caso

“…O exame histopatológico revelou linfoma não-Hodgkin. Após 15 meses da ressecção cirúrgica, a paciente mantinha-se sem sinais de recorrências ou disseminação sistêmica do tumor (1) . Huisman et al (9) descreveram um caso de linfoma primário de seio cavernoso na infância que evoluiu para óbito após três meses do diagnóstico (9) .…”

“…Linfoma maligno primário no sistema nervoso central (SNC) é raro, mas a incidência vem aumentando nas últimas décadas devido ao crescente número de pessoas imunodeprimidas (p.ex: síndrome da imunodeficiência adquirida (SIDA) e transplantes de órgãos) (1) . As manifestações clínicas da doença neurológica secundária ao linfoma maligno dependem das estruturas acometidas que incluem parênquima cerebral, leptomeninges, vasculatura cerebral e os nervos cranianos e periféricos (2)(3) .…”