• Bi Yi Chen, Vivien Chen, Shafqat Inam, Charlotte Yin, and Omprakash Damodaran.
• Concord General Repatriation Hospital, Concord, Australia. Electronic address: chen.m.biyi@gmail.com.
• World Neurosurg. 2019 Aug 1; 128: 18-22.

BackgroundCentral nervous system (CNS) relapse is an uncommon complication of diffuse large B cell lymphoma and is associated with significant mortality and morbidity. It is becoming a more prevalent pathologic entity in the rituximab era. Our case provides insight into the pathophysiology, diagnosis, prevention, and management of secondary intraventricular CNS lymphomas.Case DescriptionWe report an unusual case of a 64-year-old man who presented with an isolated secondary CNS lymphoma involving the choroid plexus in a diffuse pattern. He initially presented with obstructive hydrocephalus from diffuse choroid plexus lesions and was commenced on systemic therapy after confirmation of diagnosis via samples obtained from an open biopsy.ConclusionsThis case highlights the lack of high-quality evidence behind the use of high-dose intravenous methotrexate as CNS prophylaxis. The case provides additional insight into the pathophysiology of intraventricular CNS lymphomas and the importance of establishing a histopathologic diagnosis via an open biopsy before the administration of high-dose steroids.Crown Copyright © 2019. Published by Elsevier Inc. All rights reserved.

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