Primary Central Nervous System Lymphoma Mimicking the Presentation of Pituitary Apoplexy: A Case Report
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.26/49882 |
Resumo: | Pituitary lymphoma is one of the rare variants of primary central nervous system lymphoma (PCNSL), mostly arising due to the metastatic spread of systemic lymphoma. We report the case of a 69-year-old woman who initially presented to her family physician with a headache but without any other symptoms. The MRI scan revealed a sellar mass consistent with a pituitary macroadenoma. When the patient was referred to our hospital, two weeks later, the symptoms had progressed, comprising complete right-sided ophthalmoplegia and ptosis, with left-sided amaurosis. A repeat MRI revealed an increased size of the sellar mass, consistent with pituitary apoplexy. A right pterional craniotomy with partial resection of the mass was performed and an intraoperative frozen section biopsy was carried out. The final pathology revealed diffuse large B-cell lymphoma. A systemic follow-up including a whole-body CT, bone marrow aspiration, and cerebrospinal fluid studies ruled out any systemic manifestation, and the patient was HIV-negative. The patient underwent treatment with methotrexate, cytarabine, thiotepa, and rituximab for PCNSL. Although rare, PCNSL can mimic pituitary apoplexy, which needs to be considered if conservative therapy or surgery is to be offered to a patient with a radiological and clinical diagnosis of pituitary apoplexy. |
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Primary Central Nervous System Lymphoma Mimicking the Presentation of Pituitary Apoplexy: A Case ReportNeoplasias do Sistema Nervoso CentralApoplexia HipofisáriaCentral Nervous System NeoplasmsPituitary ApoplexyPituitary lymphoma is one of the rare variants of primary central nervous system lymphoma (PCNSL), mostly arising due to the metastatic spread of systemic lymphoma. We report the case of a 69-year-old woman who initially presented to her family physician with a headache but without any other symptoms. The MRI scan revealed a sellar mass consistent with a pituitary macroadenoma. When the patient was referred to our hospital, two weeks later, the symptoms had progressed, comprising complete right-sided ophthalmoplegia and ptosis, with left-sided amaurosis. A repeat MRI revealed an increased size of the sellar mass, consistent with pituitary apoplexy. A right pterional craniotomy with partial resection of the mass was performed and an intraoperative frozen section biopsy was carried out. The final pathology revealed diffuse large B-cell lymphoma. A systemic follow-up including a whole-body CT, bone marrow aspiration, and cerebrospinal fluid studies ruled out any systemic manifestation, and the patient was HIV-negative. The patient underwent treatment with methotrexate, cytarabine, thiotepa, and rituximab for PCNSL. Although rare, PCNSL can mimic pituitary apoplexy, which needs to be considered if conservative therapy or surgery is to be offered to a patient with a radiological and clinical diagnosis of pituitary apoplexy.Repositório ComumMeira Goncalves, JPolónia, PPereira, JSilva, PA2024-02-18T22:12:47Z20232023-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.26/49882engCureus . 2023 Dec 21;15(12):e50912.10.7759/cureus.50912info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-02-21T18:25:20Zoai:comum.rcaap.pt:10400.26/49882Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:10:42.904152Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Primary Central Nervous System Lymphoma Mimicking the Presentation of Pituitary Apoplexy: A Case Report |
title |
Primary Central Nervous System Lymphoma Mimicking the Presentation of Pituitary Apoplexy: A Case Report |
spellingShingle |
Primary Central Nervous System Lymphoma Mimicking the Presentation of Pituitary Apoplexy: A Case Report Meira Goncalves, J Neoplasias do Sistema Nervoso Central Apoplexia Hipofisária Central Nervous System Neoplasms Pituitary Apoplexy |
title_short |
Primary Central Nervous System Lymphoma Mimicking the Presentation of Pituitary Apoplexy: A Case Report |
title_full |
Primary Central Nervous System Lymphoma Mimicking the Presentation of Pituitary Apoplexy: A Case Report |
title_fullStr |
Primary Central Nervous System Lymphoma Mimicking the Presentation of Pituitary Apoplexy: A Case Report |
title_full_unstemmed |
Primary Central Nervous System Lymphoma Mimicking the Presentation of Pituitary Apoplexy: A Case Report |
title_sort |
Primary Central Nervous System Lymphoma Mimicking the Presentation of Pituitary Apoplexy: A Case Report |
author |
Meira Goncalves, J |
author_facet |
Meira Goncalves, J Polónia, P Pereira, J Silva, PA |
author_role |
author |
author2 |
Polónia, P Pereira, J Silva, PA |
author2_role |
author author author |
dc.contributor.none.fl_str_mv |
Repositório Comum |
dc.contributor.author.fl_str_mv |
Meira Goncalves, J Polónia, P Pereira, J Silva, PA |
dc.subject.por.fl_str_mv |
Neoplasias do Sistema Nervoso Central Apoplexia Hipofisária Central Nervous System Neoplasms Pituitary Apoplexy |
topic |
Neoplasias do Sistema Nervoso Central Apoplexia Hipofisária Central Nervous System Neoplasms Pituitary Apoplexy |
description |
Pituitary lymphoma is one of the rare variants of primary central nervous system lymphoma (PCNSL), mostly arising due to the metastatic spread of systemic lymphoma. We report the case of a 69-year-old woman who initially presented to her family physician with a headache but without any other symptoms. The MRI scan revealed a sellar mass consistent with a pituitary macroadenoma. When the patient was referred to our hospital, two weeks later, the symptoms had progressed, comprising complete right-sided ophthalmoplegia and ptosis, with left-sided amaurosis. A repeat MRI revealed an increased size of the sellar mass, consistent with pituitary apoplexy. A right pterional craniotomy with partial resection of the mass was performed and an intraoperative frozen section biopsy was carried out. The final pathology revealed diffuse large B-cell lymphoma. A systemic follow-up including a whole-body CT, bone marrow aspiration, and cerebrospinal fluid studies ruled out any systemic manifestation, and the patient was HIV-negative. The patient underwent treatment with methotrexate, cytarabine, thiotepa, and rituximab for PCNSL. Although rare, PCNSL can mimic pituitary apoplexy, which needs to be considered if conservative therapy or surgery is to be offered to a patient with a radiological and clinical diagnosis of pituitary apoplexy. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023 2023-01-01T00:00:00Z 2024-02-18T22:12:47Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.26/49882 |
url |
http://hdl.handle.net/10400.26/49882 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Cureus . 2023 Dec 21;15(12):e50912. 10.7759/cureus.50912 |
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info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
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application/pdf |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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