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Kurucu N, Akyüz C, Varan A, Akçören Z, Aydin B, Yalçin B, Kutluk T. Primary Paraspinal and Spinal Epidural Non-Hodgkin Lymphoma in Childhood. J Pediatr Hematol Oncol 2021; 43:e395-e400. [PMID: 32520843 DOI: 10.1097/mph.0000000000001858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 05/10/2020] [Indexed: 11/26/2022]
Abstract
Primary paraspinal/spinal epidural lymphoma (PPSEL) is rare in childhood. Here, we retrospectively evaluated patients with PPSEL treated in our department. We also reviewed the cases reported in the literature. Fifteen of 1354 non-Hodgkin lymphoma cases diagnosed over a 38-year period were PPSEPL. There were 11 male individuals and 4 female individuals with a median age of 13 years. Most common symptoms were pain and limb weakness. Physical examination revealed spinal cord compression in 80% of patients. The most common tumor location was the lumbar region. Histopathologic subtypes were lymphoblastic lymphoma in 6 and Burkitt lymphom in 5 patients. Subtotal or near-total excision of the tumor with laminectomy was performed in 6 patients. Thirteen and 9 patients received chemotherapy and radiotherapy, respectively. Neurologic recovery was observed in 70% of patients. Seven patients were alive without disease at a median of 88 months. Overall and event-free survival rates were 61.7% and 50.1%, respectively. We reviewed clinical features, treatment, and outcome of 69 PPSEL cases reported in the literature. Neurologic recovery and long-term survival was achieved in 66.7% of them. Heterogeneity in diagnostic methods and treatment have made it difficult to establish the prognostic indicators for neurologic outcome and survival. Multicenter prospective studies with more cases are necessary to determine the prognostic factors.
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Affiliation(s)
- Nilgün Kurucu
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine
| | - Canan Akyüz
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine
| | - Ali Varan
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine
| | - Zuhal Akçören
- Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Burça Aydin
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine
| | - Bilgehan Yalçin
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine
| | - Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine
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Zileli M, Sharif S, Fornari M, Ramani P, Jian F, Fessler R, Kim SH, Takami T, Shimokawa N, Dechambenoit G, Qureshi M, Konovalov N, Masini M, Osorio-Fonseca E, Sanchez JAS, Bajamal AH, Parthiban J, Sih IM, Alves ÓL, Oertel J, Rasulic L, Costa F, Peul WC, Sharma K, Eldin MM, Ismail NJ, Esene IN, Hossain M, Kalevski S, Hausmann ON, Yaman O, Arif S, Brady Z. History of Spinal Neurosurgery and Spine Societies. Neurospine 2020; 17:675-694. [PMID: 33401848 PMCID: PMC7788429 DOI: 10.14245/ns.2040622.311] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/16/2020] [Accepted: 11/21/2020] [Indexed: 11/19/2022] Open
Affiliation(s)
- Mehmet Zileli
- Department of Neurosurgery, Ege University, Izmir, Turkey
| | - Salman Sharif
- Liaquat National Hospital & Medical College, Karachi, Pakistan
| | | | - Premenand Ramani
- Department of Neurosurgery, L.T.M. Medical College, University of Mumbai, Mumbai, India
| | - Fengzeng Jian
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Richard Fessler
- Department of Neurosurgery, Rush University Medical Center, Chicago, USA
| | - Se-Hoon Kim
- Department of Neurosurgery, Ansan Hospital, Korea University Medical Center, Ansan, Korea
| | - Toshihiro Takami
- Department of Neurosurgery, Osaka Medical College, Takatsuki, Japan
| | | | | | - Mahmood Qureshi
- President Continental Association of African Neurosurgical Socieites (CAANS), Nairobi, Kenya
| | - Nikolay Konovalov
- Department of Neurosurgery, Burdenko Institute, Moscow, Russian Federation
| | - Marcos Masini
- Department of Neurosurgery, São Paulo State University, São Paulo, Brazil
| | | | | | | | - Jutty Parthiban
- Department of Neurosurgery, Kovai Medical Center, Tamilnadu, India
| | - Ibet Marie Sih
- University of the Philippines, St. Luke’s Medical Center, Bonifacio Global City, The Philippines
| | | | - Joachim Oertel
- Department of Neurosurgery, University of Saarland, Homburg, Saar, Germany
| | - Lukas Rasulic
- Department of Neurosurgery, University of Belgrade, Clinical Center of Serbia, Belgrade, Serbia, Slovenia
| | - Francesco Costa
- Department of Neurosurgery, Humanitas University, Milan, Italy
| | - Wilco C. Peul
- Department of Neurosurgery, Leiden University Medical Centre, Leiden, The Netherlands
| | - Krishna Sharma
- Department of Neurosurgery, Nepal Medical College and Teaching Hospital, Kathmandu University, Kathmandu, Nepal
| | | | | | - Ignatius Ngene Esene
- Neurosurgery Division, Faculty of Health Sciences, University of Bamenda, Bambili, Cameroon
| | - Mohammad Hossain
- Department of Neurosurgery, Bangabandhu Shiek Mujib Medical University, Dhka, Bangladesh
| | - Svetoslav Kalevski
- Multi-profile Hospital “St Anna-Varna”, Medical University of Varna, Varna, Bulgaria
| | - Oliver N. Hausmann
- Department of Neurosurgery, Hirslanden Klinik St. Anna Lucerne, Lucerne, Switzerland
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Kim YS, Lee JK, Choi KY, Jang JW. Spinal Burkitt's Lymphoma Mimicking Dumbbell Shape Neurogenic Tumor: A Case Report and Review of the Literature. KOREAN JOURNAL OF SPINE 2015; 12:221-4. [PMID: 26512290 PMCID: PMC4623190 DOI: 10.14245/kjs.2015.12.3.221] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 08/26/2015] [Accepted: 08/26/2015] [Indexed: 01/15/2023]
Abstract
Non-Hodgkin's lymphoma (NHL), a disease which may involve the spine, is frequently associated with advanced disease. Radiculopathy caused by spinal root compression as the initial presentation in patients with NHL is very rare and thought to occur in less than 5% of cases. A 69-year-old woman complained of a history of low back pain with right sciatica for 1 month prior to admission. Computed tomography and magnetic resonance imaging of the lumbar spine showed a dumbbell-shape epidural mass lesion extending from L2 to L3, which was suggestive of a neurogenic tumor. After paraspinal approach and L2 lower half partial hemilaminectomy, total excision of the tumor was achieved, followed by rapid improvement of back pain and radiating pain. The lesion was confirmed to be Burkitt's lymphoma by histopathological examination. We then checked whole-body PET-CT, which showed multifocal malignant lesions in the intestine, liver, bone and left supraclavicular lymph node. Although a rare situation, Burkitt's lymphoma should be considered in the differential diagnosis for patients presenting with back and lumbar radicular pain without a prior history of malignancy. Burkitt's lymphoma could be the cause of dumbbell-shape spinal tumor.
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Affiliation(s)
- You-Sub Kim
- Department of Neurosurgery, Chonnam National University Medical School & Research Institute of Medical Sciences, Gwangju, Korea
| | - Jung-Kil Lee
- Department of Neurosurgery, Chonnam National University Medical School & Research Institute of Medical Sciences, Gwangju, Korea
| | - Ki-Young Choi
- Department of Neurosurgery, Chonnam National University Medical School & Research Institute of Medical Sciences, Gwangju, Korea
| | - Jae-Won Jang
- Department of Neurosurgery, Chonnam National University Medical School & Research Institute of Medical Sciences, Gwangju, Korea
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Camilo GB, Machado DC, de Oliveira CE, Lacerda LDS, de Oliveira RV, Silva MDF, Lopes AJ. Burkitt lymphoma with initial clinical presentation due to infiltration of the central nervous system and eye orbits. AMERICAN JOURNAL OF CASE REPORTS 2014; 15:404-10. [PMID: 25243420 PMCID: PMC4173803 DOI: 10.12659/ajcr.891224] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Patient: Male, 17 Final Diagnosis: Burkitt lymphoma Symptoms: Anisocoria, ipsilateral ptosis, opthalmoparesis, paresis Medication: — Clinical Procedure: — Specialty: Oncology
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Affiliation(s)
| | | | | | | | | | - Monique de França Silva
- Department of Anatomic Pathology, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Postgraduate Programe in Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Paravertebral Burkitt's Lymphoma in a Child: An Unusual Presentation. Case Rep Med 2012; 2012:891714. [PMID: 23251186 PMCID: PMC3522419 DOI: 10.1155/2012/891714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Accepted: 10/12/2012] [Indexed: 11/17/2022] Open
Abstract
Paravertebral malignant tumors constitute 4.8% of cancer cases in pediatric oncology and are mostly composed of neuroblastoma (46.4%) and soft tissue sarcomas (35.7%). We describe the case of a Caucasian 6-year-old boy who was admitted for middle back pain radiated to limbs and progressively increasing weakness of the legs, suggesting a spinal cord disease. The exploration revealed two paravertebral masses extending through the neural foraminae into the epidural space. The association with elevated serum neuron specific enolase suggested at first the diagnosis of neuroblastoma, but the pathological examination revealed a Burkitt's lymphoma. This is a rare location of sporadic Burkitt's lymphoma with neurologic syndrome as first symptoms.
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Abstract
We describe a newly diagnosed HIV-infected child, without prior history of AIDS-defining disease, who presented with Burkitt lymphoma-related cauda equina syndrome that rapidly progressed to a flaccid paraplegia. Diagnosis was confirmed on biopsy and magnetic resonance imaging of the spine showed multiple epidural masses with involvement of several vertebral bodies, cord edema and compression of the cord and cauda equina. The child's immune status was relatively preserved and Epstein-Barr serology proved negative. Chemotherapy (LMB 89 modified protocol) was initiated immediately after histopathologic confirmation, together with highly active antiretroviral therapy. A follow-up magnetic resonance imaging 6 weeks later showed segmental cord atrophy at the site of previous edema despite complete resolution of all the epidural masses. Unfortunately, the child's neurologic state did not improve beyond the recovery of sphincter control and lower limb sensation. The patient is the first reported case of Burkitt lymphoma-related spinal cord compression as an initial AIDS-defining illness, in a 10-year-old child. The outcome of the case highlights the importance of early diagnosis and prompt treatment of this aggressive tumor to avoid permanent neurologic deficits.
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Fang SB, Hsiao CH, Tseng CL. Spinal Burkitt's lymphoma manifesting as nocturnal abdominal pain and constipation: a case report. ACTA ACUST UNITED AC 2003; 23:215-9. [PMID: 14567838 DOI: 10.1179/027249303322296547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
A 3-year-old boy presented at the Taiwan Adventist Hospital in Taipei with nocturnal epigastric pain and constipation. Abdominal X-ray showed colonic faecal impaction. Abdominal sonography showed gastric stasis with thickened pyloric wall and dilated rectosigmoid colons. The mouth-to-anus transit time (MATT) was prolonged. Endoscopy showed pale gastric mucosa, atony of pylorus and widening of the duodenal bulb. Three weeks after the onset of abdominal pain, he developed urinary incontinence and rapidly deteriorating paraplegia of lower limbs. Magnetic resonance imaging (MRI) showed an extradural intraspinal mass of T5-T8 and a soft tissue mass in the right superior mediastinum. After a laminectomy and tumour excision, the patient's symptoms improved quickly. The pathology revealed Burkitt's lymphoma. This is the first report of nocturnal abdominal pain and constipation as the initial manifestation of spinal Burkitt's lymphoma.
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Affiliation(s)
- Shiuh-Bin Fang
- Department of Paediatrics, Taiwan Adventist Hospital, Taipei, Taiwan.
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Abstract
Burkitt's and Burkitt-like lymphoma (BL/BLL) are aggressive B-cell malignancies with a high proliferative rate that may be fatal within months if not treated promptly. Furthermore, treatment of BL/BLL requires comprehensive supportive care to avoid disease-related complications such as acute renal failure secondary to tumor lysis syndrome. Improvements in our understanding of the biology of BL and BLL have led to more effective therapeutic protocols. Clinical trials have demonstrated that short duration, multi-agent, dose-intensive chemotherapy regimens combined with aggressive central nervous system therapy results in long-term survival rates in children and young adults near 70% to 80%, whereas long-term disease-free survival rates in older adults remains suboptimal at 15% to 25%. Outcomes in HIV-associated BL/BLL are improved because of more effective chemotherapy regimens and enhanced HIV care. Autologous bone marrow transplantation has proven feasible in many patient populations with BL/BLL and may lead to cure in selected patients. Improved therapeutic strategies are warranted, such as integrating agents such as monoclonal antibodies to combination dose-intensive chemotherapy. Moreover, further study into the molecular biology of BL/BLL with attention to the role of c-myc dysregulation is needed to help predict prognostic factors and for the development of molecular targeted therapies. Clinical trials remain critical to determine the most effective treatment regimens that will continue to improve cure rates in this aggressive but treatable disease.
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Affiliation(s)
- Andrew M Evens
- Division of Hematology/Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine Medical School and the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, 676 N. St. Clair, Suite 850, Chicago, IL 60611, USA
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