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Kawajiri T, Takeuchi H, Takahashi Y, Shimura Y, Kuroda J, Hashimoto N. Biopsy-proven Primary CNS Lymphoma in the Medulla Oblongata Presenting as Anorexia. NMC Case Rep J 2023; 10:131-137. [PMID: 37293194 PMCID: PMC10247218 DOI: 10.2176/jns-nmc.2022-0399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/06/2023] [Indexed: 06/10/2023] Open
Abstract
Eating disorders caused by brain tumors are infrequently seen. Recent studies revealed that a neurocircuit from the nucleus tractus solitarius of the medulla oblongata to the hypothalamus participates in the control of appetite. Among brain tumors, those located in the brain stem, especially a solitary one in the medulla oblongata, are rare. Tumors in the brainstem are generally considered gliomas, and with the difficulty in reaching the lesion, treatment without histological confirmation is often performed. However, there are a few reported cases of medulla oblongata tumors other than gliomas. We describe a case of a 56-year-old man who presented with persistent anorexia. Magnetic resonance images revealed a solitary tumor in the medulla oblongata. After several examinations, craniotomy for the biopsy of the tumor using the cerebellomedullary fissure approach was carried out and primary central nervous system lymphoma (PCNSL) was histologically proven. The patient was treated with effective adjuvant therapy and was discharged home after he recovered from the symptoms. No tumor recurrence was recognized 24 months after surgery. A PCNSL arising only from the medulla oblongata is very rare, and anorexia can be an initial symptom of a tumor in the medulla oblongata. Surgical intervention is safely achieved and is a key to a better clinical outcome.
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Affiliation(s)
- Takaharu Kawajiri
- Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Kyoto, Japan
| | - Hayato Takeuchi
- Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Kyoto, Japan
| | - Yoshinobu Takahashi
- Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Kyoto, Japan
| | - Yuji Shimura
- Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Kyoto, Japan
| | - Junya Kuroda
- Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Kyoto, Japan
| | - Naoya Hashimoto
- Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Kyoto, Japan
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Chen J, Cen B, Hu F, Qiu Y, Xiao G, Zhou J, Ma X, Zhang F. Primary Brainstem Lymphoma: A Population-Based Study. Front Surg 2022; 9:829048. [PMID: 35874127 PMCID: PMC9299248 DOI: 10.3389/fsurg.2022.829048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPrimary brainstem lymphoma (PBSL) is rare and malignant. An understanding of this disease is lacking. We aimed to characterize clinical features, estimate survival, and explore survival-related factors of PBSL.MethodsPatients with a histological diagnosis of primary lymphoma in the brainstem (C71.7) from 1975 to 2016 were retrieved from the Surveillance, Epidemiology, and End Results (SEER) program. Log-rank tests and univariate and multivariate Cox proportional hazard analyses were used to identify survival-related factors.ResultsPBSL constituted 2.7% of brainstem malignancies. The median age of the PBSL patients was 59.5 years. Diffuse large B cell lymphoma (n = 49, 84.5%) was the most prevalent histology among the 58 cases with reported specific lymphoma subtype. The majority of PBSLs were localized (n = 46, 52.3%), at low Ann Arbor Stage (I/II, n = 63, 70.5%), and presented as a single primary (n = 71, 80.7%). Chemotherapy was applied in 50 (56.8%) cases. Three-year overall survival (OS) and disease-specific survival (DSS) rates were 42.7% and 53.5%, respectively. Multivariate analyses showed that independent predictive/prognostic factors for OS were age (P = 0.004), tumor number (P = 0.029), and chemotherapy (P = 0.001); DSS-related factors only included age (P = 0.014) and chemotherapy (P = 0.008).ConclusionsWe estimated survival rates for PBSL patients. Factors associated with OS and DSS were also identified. Our findings addressed the importance of chemotherapy in treating PBSL patients.
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Affiliation(s)
- Junyu Chen
- General Hospital of the Yangtze River Shipping, Wuhan Brain Hospital, Wuhan, China
| | - Bo Cen
- General Hospital of the Yangtze River Shipping, Wuhan Brain Hospital, Wuhan, China
| | - Fei Hu
- General Hospital of the Yangtze River Shipping, Wuhan Brain Hospital, Wuhan, China
| | - Yong Qiu
- General Hospital of the Yangtze River Shipping, Wuhan Brain Hospital, Wuhan, China
| | - Guomin Xiao
- General Hospital of the Yangtze River Shipping, Wuhan Brain Hospital, Wuhan, China
| | - Junge Zhou
- General Hospital of the Yangtze River Shipping, Wuhan Brain Hospital, Wuhan, China
| | - Xiujian Ma
- German Cancer Research Center (DKFZ), DKFZ-ZMBH Alliance, Heidelberg, Germany
- Correspondence: Fangcheng Zhang Xiujian Ma
| | - Fangcheng Zhang
- Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Correspondence: Fangcheng Zhang Xiujian Ma
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