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Primary Cerebral Lymphoma With Isolated Vitreoretinal and Cerebral Recurrences Without Meningeosis: A Case Report.

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December 2024

Treatment Resistant Schizophrenia Outpatient Clinic, Júlio de Matos Hospital, São José Local Health Unit, Clinical Academic Center of Lisbon, Lisbon, PRT.

Primary central nervous system lymphoma (PCNSL) is a diffuse, large B-cell lymphoma affecting the brain, spinal cord, leptomeninges, or eyes. A patient with a recurrence of a previous PCNSL manifesting as an isolated vitreoretinal disease without central nervous system (CNS) involvement and a second cerebral recurrence without vitreoretinal involvement has not yet been reported. The patient is an 86-year-old man with PCNSL of the left cerebellum diagnosed at the age of 82 years and treated with suboccipital trepanation and resection of the lesion followed by chemotherapy.

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Purpose: The prognosis of relapsed primary central nervous system lymphoma remains a concern. This study aimed to compare the effects of various patient- and disease-related factors on the prognosis of relapsed primary central nervous system lymphoma (PCNSL).

Methods: We retrospectively collected real-world data from eight Finnish hospitals on 198 patients diagnosed with PCNSL between 2003 and 2020.

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The present study reports a single-center experience conducted at Józef Struś Multispecialty City Hospital in Poznań, Poland, in diagnosing and treating two patients with primary central nervous system lymphoma (PCNSL), one immunocompetent and one immunodeficient (AIDS). PCNSL is an extremely rare neoplasm with a poor prognosis and non-specific treatment on the basis of immunocompetency. Standard treatment consists of high-dose methotrexate (HD-MTX) being the background of a multimodal therapy, including other chemotherapeutic agents with and without radiation.

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Background: Diffuse large B-cell lymphoma (DLBCL) is one of the most common complications in patients with Acquired Immune Deficiency Syndrome (AIDS), yet its prognosis is generally poor. The impact of surgery on DLBCL remains controversial. We present a case of DLBCL associated with HIV infection, in which the patient achieved complete remission following surgical removal, radiotherapy, and sequential dose-adjusted EPOCH (DA-EPOCH) chemotherapy.

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Advances in Primary Central Nervous System Lymphoma.

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November 2024

Department of Neurology and Neurological Sciences, Stanford University School of Medicine, 875 Blake Wilbur, MC 6510, Stanford, Palo Alto, CA, 94305, USA.

Article Synopsis
  • This article reviews the importance of optimal initial management in primary CNS lymphoma (PCNSL) and its potential impact on long-term patient outcomes.
  • Recent advances include using genomic analysis of CSF cell-free DNA for diagnosis and improved treatment options for younger patients, where chemotherapy has shown high cure rates.
  • In contrast, older patients still face poor outcomes, prompting investigations into new therapies and consolidation options like low-dose radiation, while ongoing clinical trials aim to address their treatment needs.
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