Matsubara H, Watanabe KI, Sakai H, Chang H, Fujino H, Higashi Y, Kobayashi M, Adachi S, Seto S, Nakahata T. Rapid improvement of paraplegia caused by epidural involvements of Burkitt's lymphoma with chemotherapy.
Spine (Phila Pa 1976) 2004;
29:E4-6. [PMID:
14699290 DOI:
10.1097/01.brs.0000105540.76773.9c]
[Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN
Case report.
OBJECTIVE
The authors present a case of atypical Burkitt's lymphoma with multiple epidural involvements.
SUMMARY OF BACKGROUND DATA
Spinal cord compression in children is an emergency that requires urgent attention to minimize neurologic dysfunction. Although it is not life-threatening in most patients, cord compression can cause severe neurologic morbidity.
MATERIALS AND METHODS
Because the patient showed rapid neurologic deterioration, we started chemotherapy and high-dose steroids without laminectomy or radiotherapy immediately after a tumor biopsy from the left mandible.
RESULT
The combined therapies were very effective and his neurologic symptoms improved immediately. The epidural involved masses disappeared in imaging studies after the first course of chemotherapy including methylprednisolone (20 mg/kg per day for 3 consecutive days and gradually tapered off over 2 weeks), vincristine (1.5 mg/m2 per day), cyclophosphamide (2 g/m2 per day for 2 days) and pirarubicin (40 mg/m2 per day). After completing seven courses of chemotherapy, the patient is now fully ambulant.
CONCLUSION
Considering the severe late effects of laminectomy and radiotherapy, chemotherapy should be considered as a first choice of treatment for spinal cord compression caused by malignant lymphoma.
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