Case Report: Concurrent primary CNS lymphoma and meningothelial meningioma - nuances of diagnosis and management [version 2; peer review: 1 approved, 2 approved with reservations]
Background: The incidence of two distinct primary intracranial pathologies is an exceedingly rare phenomenon. Although meningiomas are well known to coexist with other primary intracranial malignancies there are only nine reported cases of a meningioma occurring simultaneously with primary CNS lymph...
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F1000 Research Ltd
2019-08-01
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| author | Rosalinda Menoni Ira Bowen Dan Miulli Jacob Bernstein Samir Kashyap |
| author_facet | Rosalinda Menoni Ira Bowen Dan Miulli Jacob Bernstein Samir Kashyap |
| author_sort | Rosalinda Menoni |
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| description | Background: The incidence of two distinct primary intracranial pathologies is an exceedingly rare phenomenon. Although meningiomas are well known to coexist with other primary intracranial malignancies there are only nine reported cases of a meningioma occurring simultaneously with primary CNS lymphoma in the literature. We report a case of a woman who sustained multiple injuries due to two distinct intracranial pathologies, however, lateralizing signs were unrecognized for two weeks prior to her final diagnosis. Case Description: A 64-year-old female with history of diabetes mellitus type 2 initially presented to the Emergency Department, two weeks prior, following a mechanical fall at home resulting in a left bimalleolar fracture. CT imaging revealed a right occipital mass with significant vasogenic edema causing 12mm of midline shift. MRI revealed two distinct homogeneously contrast-enhancing lesions: a right occipital mass with dural-based attachment, as well as a homogenously contrast-enhancing lesion adjacent to the right posterolateral ventricle. FLAIR signal changes were also appreciated and were noted to extend across the corpus callosum, raising concerns for a high-grade glial process. She underwent a right occipital craniotomy with gross total resection of the right occipital mass as well as subtotal resection and biopsy of the second lesion. Final pathology of the extra-axial lesion was found to be meningothelial meningioma and the deep lesion was found to be diffuse large B-cell lymphoma. Discussion: We describe a rare instance of simultaneous meningioma and primary CNS lymphoma that was found to be the underlying cause of a traumatic injury several weeks after the incident. We review the current diagnosis and management nuances in the setting of multiple intracranial oncologic processes. |
| format | Article |
| id | doaj-art-723dc60b751d4149806a08c03b7c2e71 |
| institution | OA Journals |
| issn | 2046-1402 |
| language | English |
| publishDate | 2019-08-01 |
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| spelling | doaj-art-723dc60b751d4149806a08c03b7c2e712025-08-20T01:47:22ZengF1000 Research LtdF1000Research2046-14022019-08-01810.12688/f1000research.17770.222421Case Report: Concurrent primary CNS lymphoma and meningothelial meningioma - nuances of diagnosis and management [version 2; peer review: 1 approved, 2 approved with reservations]Rosalinda Menoni0Ira Bowen1Dan Miulli2Jacob Bernstein3Samir Kashyap4https://orcid.org/0000-0003-0777-3172Department of Neurosurgery, Riverside University Health System, Riverside, CA, 92555, USADepartment of Neurosurgery, Riverside University Health System, Riverside, CA, 92555, USADepartment of Neurosurgery, Riverside University Health System, Riverside, CA, 92555, USADepartment of Neurosurgery, Riverside University Health System, Riverside, CA, 92555, USADepartment of Neurosurgery, Riverside University Health System, Riverside, CA, 92555, USABackground: The incidence of two distinct primary intracranial pathologies is an exceedingly rare phenomenon. Although meningiomas are well known to coexist with other primary intracranial malignancies there are only nine reported cases of a meningioma occurring simultaneously with primary CNS lymphoma in the literature. We report a case of a woman who sustained multiple injuries due to two distinct intracranial pathologies, however, lateralizing signs were unrecognized for two weeks prior to her final diagnosis. Case Description: A 64-year-old female with history of diabetes mellitus type 2 initially presented to the Emergency Department, two weeks prior, following a mechanical fall at home resulting in a left bimalleolar fracture. CT imaging revealed a right occipital mass with significant vasogenic edema causing 12mm of midline shift. MRI revealed two distinct homogeneously contrast-enhancing lesions: a right occipital mass with dural-based attachment, as well as a homogenously contrast-enhancing lesion adjacent to the right posterolateral ventricle. FLAIR signal changes were also appreciated and were noted to extend across the corpus callosum, raising concerns for a high-grade glial process. She underwent a right occipital craniotomy with gross total resection of the right occipital mass as well as subtotal resection and biopsy of the second lesion. Final pathology of the extra-axial lesion was found to be meningothelial meningioma and the deep lesion was found to be diffuse large B-cell lymphoma. Discussion: We describe a rare instance of simultaneous meningioma and primary CNS lymphoma that was found to be the underlying cause of a traumatic injury several weeks after the incident. We review the current diagnosis and management nuances in the setting of multiple intracranial oncologic processes.https://f1000research.com/articles/8-103/v2CNS lymphoma Meningioma Collision tumoreng |
| spellingShingle | Rosalinda Menoni Ira Bowen Dan Miulli Jacob Bernstein Samir Kashyap Case Report: Concurrent primary CNS lymphoma and meningothelial meningioma - nuances of diagnosis and management [version 2; peer review: 1 approved, 2 approved with reservations] F1000Research CNS lymphoma Meningioma Collision tumor eng |
| title | Case Report: Concurrent primary CNS lymphoma and meningothelial meningioma - nuances of diagnosis and management [version 2; peer review: 1 approved, 2 approved with reservations] |
| title_full | Case Report: Concurrent primary CNS lymphoma and meningothelial meningioma - nuances of diagnosis and management [version 2; peer review: 1 approved, 2 approved with reservations] |
| title_fullStr | Case Report: Concurrent primary CNS lymphoma and meningothelial meningioma - nuances of diagnosis and management [version 2; peer review: 1 approved, 2 approved with reservations] |
| title_full_unstemmed | Case Report: Concurrent primary CNS lymphoma and meningothelial meningioma - nuances of diagnosis and management [version 2; peer review: 1 approved, 2 approved with reservations] |
| title_short | Case Report: Concurrent primary CNS lymphoma and meningothelial meningioma - nuances of diagnosis and management [version 2; peer review: 1 approved, 2 approved with reservations] |
| title_sort | case report concurrent primary cns lymphoma and meningothelial meningioma nuances of diagnosis and management version 2 peer review 1 approved 2 approved with reservations |
| topic | CNS lymphoma Meningioma Collision tumor eng |
| url | https://f1000research.com/articles/8-103/v2 |
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