Primary Bone Burkitt’s like Lymphoma of the Skull Mimicking Meningioma - Case Report and Review of Literature

Abstract

Primary Bone Lymphoma of the skull is extremely rare and has a variable clinical course and prognosis. We are describing a case of a 26 year old woman who presented with a 2 year history of intermittent scalp swelling and skull pain. Brain MRI showed thickening of the bilateral frontal bones and band thickening of the underlying meninges suggestive of band meningiomatosis. Patient was presumably diagnosed with a meningioma based on radiological findings and underwent resection; however, pathology was consistent with a B-cell lymphoma with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma. A PET CT scan showed sacral bone hypermetabolic lesion which was biopsied and consistent with same lymphoma features. She received chemotherapy with Rituximab and Hyper-CVAD protocol (Table 1) and had a sustained ongoing complete remission 19 months after her initial diagnosis. Several cases of primary lymphoma of the skull or cranial vault have been described in the literature, but only one other case with the same pathology of Burkitt- like lymphoma was found.