gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

Non-Hodgkin lymphomas derived from the cancellous skull bone: presentation of two cases

Primäre hochmaligne B-Zell-Lymphome des knöchernen Schädels: Darstellung von zwei Fällen

Meeting Abstract

  • corresponding author O. Müller - Universitätsklinikum Essen, Neurochirurgische Klinik und Poliklinik, Essen
  • J.P. Regel - Universitätsklinikum Essen, Neurochirurgische Klinik und Poliklinik, Essen
  • D. Müller - Universitätsklinikum Essen, Neurochirurgische Klinik und Poliklinik, Essen
  • F. Rauhut - Universitätsklinikum Essen, Neurochirurgische Klinik und Poliklinik, Essen
  • J.A.P. van de Nes - Universitätsklinikum Essen, Institut für Neuropathologie, Essen
  • D. Stolke - Universitätsklinikum Essen, Neurochirurgische Klinik und Poliklinik, Essen

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 08.106

The electronic version of this article is the complete one and can be found online at:

Published: May 8, 2006

© 2006 Müller et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: To present two cases of high-malignant lymphomas who presented with a mass lesion in the cancellous bone of the skull. None of the patients had a history of previous lymphomas. The pathology of these tumours is elucidated, the therapy for these mass lesions and a review of the current literature is given. Primary manifestation of Non-Hodgkin lymphomas in the central nervous system are a rare entity, accounting for less the 2% of brain tumours. These tumours generally originate from B-cells but may also derive from T-cell lines.

Methods: Two female patients, aged 56 and 64 years, presented at our department with a history of painful swelling of the skull. The time interval from onset of symptoms to presentation in our clinic was approximately 4 months in both cases. The physical and neurological examination was normal in both females, except for the gross and tender mass lesions, one frontal and the other left parietal. Radiological examination with CT and MRI revealed contrast-enhanced mass lesions of the skull with destruction of the bone and epidural tumour growth. Because of the destructive nature of these tumours, surgery was indicated and informed consent was given. Complete tumour removal was achieved by a bifrontal and parietal craniectomy respectively.

Results: The histopathological examination diagnosed malignant B-cell lymphomas of a high malignancy in both cases. Further staging showed no secondary manifestation of the disease, thus the cranial lesions being the only manifestation of the lymphoma. The bone defect was covered with PMMA in one patient, and with a titanium implant (CCB-11068) in the other. Chemotherapy was begun after primary wound healing. When last seen, the patients were well and remained tumour free.

Conclusions: To our best knowledge these are the first reported malignant B-cell lymphomas deriving from the cancellous bone of the skull. The B-cell lymphoma is well responding to chemotherapy, though it tends to relapse due to its highly malignant nature. The radical resection of the tumour lesions in these cases may have provided the tumour-free survival of these patients for over 24 months in one patient so far. We recommend therefore, that in bone-derived B-cell lymphomas accessible for an operation a radical tumour resection should be achieved.