Abstract
A 54-year-old male was admitted in April, 1983, because of progressive neurological symptoms. On neurological examination, the patient was stuporous, had right hemiparesis, expressive aphasia, bilateral papilledema and right sixth cranial nerve paresis. A computerized tomography (CT) scan demonstrated a mass in the left thalamus with a marked enhancement after contrast administration. Left carotid angiography showed a vascular stain in the same region. Prednisolone was given intramuscularly, at a dose of 20 mgday. Ten days later, an improvement of neurological findings were observed. A CT scan at this time revealed the mass lesion was markedly decreased in size. In June, a stereotaxic biopsy of the mass in the thalamus showed a malignant lymphoma. After this procedure, whole brain irradiation at a total dose of 4, 000 rad and a local dose of 2, 000 rad was given. Prednisolone therapy was continued. A CT scan taken after irradiation demonstrated disappearance of the tumor mass and also, improved neurological symptoms.
Seven cases of primary malignant lymphoma of the brain which showed remission in conjunction with the administration of glucocorticoids have been previously reported. It is thought that glucocorticoids may have a direct cytotoxic effect on the lymphoma cell or that glucocorticoids may favorably alter the biologic activity of tumor tissue in some cases.
