gms | German Medical Science

Objective: Manifestation of malignant lymphomas in the spine is rare. There are only few case reports in the literature. Due to its rarity there is no gold standard for the management of patients suffering from spinal lymphoma manifestation.

Methods: We retrospectively reviewed the data for 25 patients (10 female, 15 male) with malignant lymphoma in the spine receiving surgery in our center from March 2006 till April 2017. Neurological impairment, pain, diagnostics and/or surgical instability were the criteria for intervention in this patient cohort. In case of neurological impairment, pain and/or spinal instability surgery was conducted. Otherwise CT guided biopsy only was conducted. Analysis of the patient cohort based on using Frankel-Score, location of the lesion, spinal levels of tumor involved, surgical treatment, histopathological workup, adjuvant therapy, functional outcome and overall survival.

Results: The following surgical procedures were performed: a posterior stabilization and decompression in eight patients, tumor debulking and decompression in 14 patients, two patients received CT-guided biopsy only and one kyphoplasty. 17 patients (65,4%) had ≥1 lesion in the thoracic spine, 6 patients (23,1%) in the lumbar spine and one in the sacrum. The histopathology diagnoses caused by immunhistochemical tests was diffuse large B-cell Lymphoma in 14 cases, low-grade Lymphoma in 10 cases and Burkitt Lymphoma in one case. The median overall survival was 695 days (range 6-2482 days).

Preoperative KPS was 70% (range 30-90%), the postoperative KPS was 70% (range 20-90%).

Conclusion: Manifestation of malignant lymphomas in the spine is a rare disease. Similar to other entities of spine metastases a surgical intervention in case of neurological impairment is indicated followed by chemotherapy and radiotherapy.