Stage IV Hodgkin's Disease presenting with spinal epidural involvement and cauda equina compression as the initial manifestation: Case report

Toprak, Ahmet; Kodallı, Nihat; Alpdogan, Tulin Budak; Giral, Adnan; Çelikel, Çiğdem; Gurmen, Nevzat; Bayık, Mahmut

doi:10.1038/sj.sc.3100498

Cited by 9 publications

(19 citation statements)

References 10 publications

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“…13 Less frequently, the infiltration of the lymphomatous tissue from the vertebral body into the anterior part of the epidural space has been reported in HD. 2 It has also been stated that lymphoid rests are present in the epidural space. 14 These rests may give rise to a malignant transformation to produce isolated primary spinal epidural lymphoma.…”

Section: Discussionmentioning

confidence: 98%

“…1 To our knowledge, epidural cauda equina compression as the first symptom of HD has been previously reported in only one case. 2 We describe a 14-year-old boy who had initial clinical symptoms consistent with an acute cauda equina compression that revealed Stage IV HD. A 14-year-old boy with no medical history was admitted at our emergency department for dribbling incontinence of urine and low back pain irradiating in both lower extremities.…”

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confidence: 99%

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Acute Cauda Equina Compression Revealing Hodgkin’s Disease

Riffaud

Adn²,

Brassier³

et al. 2003

Spine

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Section: Discussionmentioning

confidence: 98%

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confidence: 99%

Acute Cauda Equina Compression Revealing Hodgkin’s Disease

Riffaud

Adn²,

Brassier³

et al. 2003

Spine

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“…Malignant lymphoma is most commonly present in the midthoracic and lower lumbar segments. 3,17 Presentation in the cervical segments is rare because cancer appearing in the paracervical areas is usually discovered early. 2 Similar to data found in the literature, among our patients there were one cervical, eight thoracic and four lumbar lymphoma cases.…”

Section: Discussionmentioning

confidence: 99%

“…The rate of epidural occurrence in all case of MLs is rare (0.8-2.8%). [3][4][5][6][7][8][9][10] Due to this rate of occurrence small case number studies and case reports dominate the literature. Surgical intervention is recommended for epidural ML when myelocompression is found.…”

Section: Introductionmentioning

confidence: 99%

“…Non-Hodgkin's lymphoma (NHL) is about three times as common as Hodgkin's lymphoma (HL). [1][2][3][4][5] The presentation of ML can be divided into two groups: (1) the primary extranodal, and (2) the advanced, disseminated forms of the disease. Advanced stage is more commonly encountered with epidural presentation and the primary extranodal form is more common in NHL.…”

Section: Introductionmentioning

confidence: 99%

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Epidural malignant lymphomas of the spine: collected experiences with epidural malignant lymphomas of the spinal canal and their treatment

et al. 2007

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Subjects and methods: The epidural presentation in eight patients was heralded by motor signs (paraparesis and plegia), in one by a lesion of the posterior columns of the spinal cord (ataxia), and in three by pain. One patient was free of complaints and symptoms. The affected epidural area was diagnosed previously by myelography and computerized tomography (CT), and later by magnetic resonance (MR), over the course of which the location was verified as thoracic in eight patients, cervical in one, and lumbar in four. The authors recommended surgical intervention in 9 out of 13 cases, in seven cases of Hodgkin's and six cases of non-Hodgkin's lymphoma. Seven patients were treated for recognized manifestations of malignant lymphoma while six were diagnosed by intraoperativehistological examination. Results and conclusion: The decompression operations for tumors resulted in limited improvement in seven patients (reduction in pain and return of ability to walk). Four patients were not operated on, two of which had significant improvement in their neurological symptoms. Paraparesis remained unchanged in one patient. One patient remained symptom-free. The authors emphasize the importance of interdisciplinary consultation and weighing individual priorities in the indications for operation on epidural ML.

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Lumbosacral epidural lymphoma: A case report and comprehensive review of literature

Eslami,

Aledavoud,

Ilaghi

et al. 2024

Clinical Case Reports

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Key Clinical MessageEpidural lymphoma of the lumbosacral region is a rare condition that manifests with back pain and nonspecific neurological symptoms. Our case which was diagnosed with diffuse large B‐cell lymphoma, highlights the importance of recognizing early lymphoma symptoms to enable timely treatment and improved outcomes.AbstractLymphoma rarely presents in the lumbosacral epidural space. Initial presentations of lymphoma are of paramount importance in the timely diagnosis and management of the disease. We report a 42‐year‐old woman presented with 4 years of low back pain and progressive right lower extremity paresthesia. Lumbar MRI revealed an epidural soft tissue lesion compressing nerves at L4 to the coccyx. Laminectomy and tumor resection were performed. Pathologic findings confirmed diffuse large B‐cell lymphoma. We systematically reviewed the literature on lymphomas with lumbar epidural space involvement reported since 1990. Twenty‐four cases from 19 reports were identified. The mean age of lumbar epidural lymphoma cases was 39.5 ± 17.8 years, and 72% were male. The most common subtype was diffuse large B‐cell lymphoma, and common presentations included back pain, lower extremity neurological deficits, and bowel/bladder dysfunction. Overall, lymphomas presenting in the spine can pose diagnostic challenges owing to nonspecific initial symptoms. Our case highlights the importance of recognizing early lymphoma symptoms to enable timely treatment and improved outcomes.

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Stage IV Hodgkin's Disease presenting with spinal epidural involvement and cauda equina compression as the initial manifestation: Case report

Cited by 9 publications

References 10 publications

Acute Cauda Equina Compression Revealing Hodgkin’s Disease

Acute Cauda Equina Compression Revealing Hodgkin’s Disease

Epidural malignant lymphomas of the spine: collected experiences with epidural malignant lymphomas of the spinal canal and their treatment

Lumbosacral epidural lymphoma: A case report and comprehensive review of literature

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