• Tzu-Kang Lin, Tu-Hsueh Yeh, Peng-Wei Hsu, Chih-Cheng Chuang, Po-Hsun Tu, Pin-Yuan Chen, Shih-Ming Jung, Kuo-Chen Wei, and Yin-Cheng Huang.
• Department of Neurosurgery, Chang Gung Memorial Hospital, Linkou branch, Taoyuan City, Taiwan; Department of Medicine, Chang Gung University, Taoyuan City, Taiwan.
• World Neurosurg. 2017 Jul 1; 103: 550-556.

BackgroundPrimary central nervous system lymphomas (PCNSLs) are relatively rare brain tumors. Accurate diagnosis is usually made by surgical biopsy. In addition to surgical biopsy and decompression, treatment options include high-dose methotrexate and chemotherapy, radiation therapy, and stem cell therapy. Because of the rarity of this disease, guidelines for PCNSL diagnosis and treatment usually are formed from a large series of experiences.MethodsWe retrospectively reviewed 79 patients in our tertiary referral center during a 13-year period. All patients with PCNSL underwent surgical or bone marrow biopsy procedures, and diagnoses were confirmed by hematologists or neuropathologists. At the time of diagnosis, 44 patients presented with a single lesion. Human immunodeficiency virus was confirmed positive in 1 patient. The standard therapy protocol included high-dose methotrexate (intravenous and intrathecal) and chemotherapy with cytosine arabinoside, followed by external irradiation of the brain.ResultsSignificant prognostic factors in these patients were low serum lactate dehydrogenase levels and radiation therapy. Multiplicity of lesions at time of diagnosis did not imply a worse outcome, and surgical resection and debulking did not show a significant survival benefit.ConclusionsPCNSL has a poor prognosis. Further clinical trials and diagnostic tools are needed to reveal the complexity of this disease.Copyright © 2017 Elsevier Inc. All rights reserved.

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