Primary spinal Non-Hodgkin Lymphoma presenting as impending cauda equina syndrome: A case report

Annals of Medicine and Surgery, 2022 · DOI: https://doi.org/10.1016/j.amsu.2022.104696 · Published: September 15, 2022

Oncology Surgery Research Methodology & Design

Simple Explanation

Malignant lymphoma can affect the central nervous system, either as a primary tumor or through secondary spread from elsewhere in the body. Lymphoma originating as a primary tumor in the spinal cord is quite rare. A 32-year-old male presented with symptoms suggestive of impending cauda equina syndrome. He underwent surgery and chemotherapy and showed successful recovery with no relapse during the 6-month follow-up. Primary spinal non-Hodgkin lymphoma is uncommon among extranodal non-Hodgkin lymphomas. Diagnosis often requires immunohistochemistry due to non-specific MRI findings. Treatment includes surgical decompression for neurological compromise, along with chemotherapy, typically the R-CHOP regimen.

Study Duration

6 months follow-up

Participants

A 32 years old male patient

Evidence Level

Case Report

Key Findings

1
Primary spinal epidural diffuse large B-cell lymphoma should be considered in patients presenting with back pain and signs of impending cauda equina syndrome.
2
Early detection and treatment are important to prevent permanent neurological injury and metastasis.
3
Surgical decompression is recommended in patients with signs of spinal cord injury to prevent irreversible neurological damage.

Research Summary

This case report discusses a rare presentation of primary spinal non-Hodgkin lymphoma in a 32-year-old male who presented with symptoms of impending cauda equina syndrome. The patient was successfully treated with surgical decompression followed by chemotherapy (R-CHOP regimen), and showed no signs of relapse during the 6-month follow-up. The report emphasizes the importance of considering primary spinal lymphoma in the differential diagnosis of patients with back pain and cauda equina syndrome symptoms and highlights the need for early diagnosis and treatment to prevent neurological damage.

Practical Implications

Differential Diagnosis

Primary spinal epidural diffuse large B-cell lymphoma should be considered in the differential diagnosis of patients presenting with back pain and symptoms of impending cauda equina syndrome.

Early Intervention

Early detection and treatment are crucial for preventing permanent neurological injury and metastasis in cases of primary spinal lymphoma.

Treatment Strategy

Surgical decompression may be necessary in cases of impending neurological injury, followed by chemotherapy (e.g., R-CHOP regimen) to achieve a favorable outcome.

Study Limitations

1
Single case report limits generalizability.
2
Short follow-up period of 6 months.
3
MRI findings may be non-specific, requiring immunohistochemistry for accurate diagnosis.

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