ノナカ マサヒロ   NONAKA MASAHIRO
  埜中 正博
   所属   関西医科大学  脳神経外科学講座
   職種   教授
論文種別 症例報告
言語種別 英語
査読の有無 査読あり
表題 Primary malignant lymphoma of the trigeminal region treated with rapid infusion of high-dose MTX and radiation: case report and review of the literature.
掲載誌名 正式名:Surgical neurology
略  称:Surg Neurol
ISSNコード:0090301900903019
掲載区分国外
巻・号・頁 60(4),pp.343-348; discussion 348
著者・共著者 Kinoshita Manabu, Izumoto Shuichi, Oshino Satoru, Nonaka Masahiro, Moriuchi Shusuke, Maruno Motohiko, Yoshimine Toshiki
発行年月 2003/10
概要 BACKGROUND:Extra-axial primary CNS lymphoma, considered rare, mainly arise in the white matter of the brain. Though the tumor responds well to radiation and chemotherapy, the prognosis of primary CNS lymphoma remains poor. We report a case of primary lymphoma of Meckel's cave mimicking a trigeminal schwannoma radiographically, which achieved complete remission through use of rapid high-dose MTX therapy and radiation therapy.CASE DESCRIPTION:The patient, a 55-year-old Japanese male, presented left trigeminal neuralgia. Magnetic resonance imaging (MRI) revealed a mass lesion in the left side of Meckel's cave, with extension into the cerebellopontine angle and the infratemporal fossa through the foramen ovale, suggesting trigeminal schwannoma. However, the patient suffered radiologically inexplicable progressive cranial nerve palsy, which suggested malignant disease. MRI and CSF disclosed malignant tumor dissemination; biopsy revealed malignant lymphoma. The treatment, composed of the rapid infusion of high-dose MTX and whole brain and spine radiation, resulted in complete remission.CONCLUSIONS:This case, which included atypical presentation of malignant lymphoma, illustrates the importance of including malignant lymphoma in the differential diagnosis of CP-angle and Meckel's cave tumor. The results also confirmed the usefulness of combined rapid high-dose MTX therapy and radiation.
PMID 14505860