Primary central nervous system lymphoma presenting as a pure third ventricular lesion: a case report

Mehdi Sasani,Muzaffer Bayhan,Gokhan Cakiroglu,Tuncay Kaner,Ali Fahir Ozer,Tunc Oktenoglu,Hadi Sasani

doi:10.1186/1752-1947-5-213

Abstract

IntroductionPrimary central nervous system lymphomas are infrequently occurring lymphomas that account for only 0.3-1.5% of all intra-cranial neoplasms in patients without acquired immune deficiency syndrome. However, a pure third ventricle lymphoma is extremely rare. Here, we discuss the similar radiological appearances of lesions localized in the third ventricle and the importance of accurately diagnosing primary central nervous system lymphomas for favorable treatment outcomes.Case presentationA 38-year-old Caucasian man from Turkey presented with a severe headache lasting for three months that failed to respond to any medication. Both severity and duration of the symptoms increased gradually, resulting in vomiting, nausea and gait disturbance that accompanied the headache for three weeks. Neuro-imaging studies showed a lesion located solely in the third ventricle, resulting in partial obstruction of the foramen of Monro. The pre-operative diagnosis was a colloid cyst. Following the surgical procedure, the results of pathological and immunochemical assays revealed that the pre-operative diagnosis was incorrect and that the lesion was a primary central system lymphoma.ConclusionPure third ventricle lymphomas are extremely rare and are exceptionally localized. It is important to be aware of, and to differentiate between, other possible third ventricular lesions that may mimic the same radiological appearance. Accurate diagnosis is necessary for selecting appropriate treatment modalities.

Highlights

Primary central nervous system lymphomas (PCNSL) are infrequently occurring lymphomas that account for only 0.3-1.5% of all intra-cranial neoplasms in patients without acquired immune deficiency syndrome (AIDS) [1,2]
The results of this study suggest that computed tomography (CT) and magnetic resonance imaging (MRI) studies are the most reliable neuro-imaging techniques for the diagnostic and surgical management of neoplastic masses affecting this region
For proper diagnosis, it is important to differentiate between other possible third ventricle lesions that may mimic the radiological appearance of such lymphomas

Summary

Conclusion

Pure third ventricle lymphomas are extremely rare and do not normally occur with exceptional localization. A copy of the written consent is available for review by the Editor-in-Chief of this journal. In this case, the pre-operative diagnosis based on the findings of an initial MRI incorrectly indicated that the lesion was a colloid cyst. The accurate post-operative diagnosis, was PCNSL, which is rarely observed, if it is a pure third ventricle lymphoma. Author details 1American Hospital Neurosurgery Department, Nisantasi, Istanbul, Turkey. Authors’ contributions MS examined the patient, interpreted the findings and performed the surgery, and was a major contributor in writing the manuscript. MB examined the patient, interpreted the findings and performed the surgery. Competing interests The authors declare that they have no competing interests

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