P11.01 * THE ROLE OF SURGERY IN PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMAS

Abstract

INTRODUCTION: Involvement of the central nervous system (CNS) by limphoma is an uncommon variant of extranodal non-Hodgkin lymphoma (NHL). The appearance of CNS disease years after complete remission of NHL can be attributed to recurrence of the original tumor or to a second neoplasm in genetically and immunologically predisposed patients. MATERIAL AND METHODS: A descriptive analysis of all Primary Central Nervous System Lymphomas (PCNSL) treated in our institution since 1990 has been carried out. All patients have histologically confirmed PCNSL, and extent of the disease was studied with body CT scan and bone marrow biopsy. 15 cases were diagnosed, all without evidence of distant disease. RESULTS: The mean age at diagnosis was 59.3 years, with a larger proportion of males and presence of HIV disease in 33% of all patients. During the 1990′s the percentage of craniectomies is greater than during the following decade, in which biopsies prevail and the craniectomies carried out correspond to unsuspected PCNSL. Six patients had a previous history of systemic neoplasm upon diagnosis of PCNSL. CONCLUSIONS: Upon the suspicion of PCL, a stereotactic biopsy should be performed to confirm diagnosis. Biopsies of CNS lesions that appear syncronically or after treatment of other neoplasms have proven that PCNSL should be considered in the differential diagnosis of second tumors. PCNSL as a second primary tumor after extranodal NHL is a rare entity, yet such possibility should be taken into account and considered in the differential diagnosis with local relapse. In the case of metastases, treatment would have a palliative approach, whereas in second primary tumors curative treatment is attempted, with different prognostic implications.