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71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

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Clinical presentation, management and outcome in primary dural lymphomas

Klinische Präsentation, Behandlung und Therapieergebnisse von primär duralen Lymphomen

Meeting Abstract

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  • presenting/speaker Philipp Karschnia - Klinikum der Ludwig-Maximilians-Universität München, Klinik für Neurochirurgie, München, Deutschland; Massachusetts General Hospital, Klinik für Neurologie, Boston, MA, United States
  • Justin T. Jordan - Massachusetts General Hospital, Klinik für Neurologie, Boston, MA, United States
  • Tracy T. Batchelor - Massachusetts General Hospital, Klinik für Neurologie, Boston, MA, United States
  • Brian Shaw - Massachusetts General Hospital, Klinik für Neurologie, Boston, MA, United States
  • Sebastian F. Winter - Massachusetts General Hospital, Klinik für Neurologie, Boston, MA, United States
  • Frank J. Barbiero - Yale School of Medicine, Clinic for Neurology, New Haven, CT, United States
  • Leon D. Kaulen - Yale School of Medicine, Clinic for Neurology, New Haven, CT, United States
  • Niklas Thon - Klinikum der Ludwig-Maximilians-Universität München, Klinik für Neurochirurgie, München, Deutschland
  • Jörg-Christian Tonn - Klinikum der Ludwig-Maximilians-Universität München, Klinik für Neurochirurgie, München, Deutschland
  • Anita J. Huttner - Yale School of Medicine, Department of Neuropathology, New Haven, CT, United States
  • Robert K. Fulbright - Yale School of Medicine, Department of Radiology, New Haven, CT, United States
  • Jay Loeffler - Massachusetts General Hospital, Clinic for Radiotherapy, Boston, MA, United States
  • Jorg Dietrich - Massachusetts General Hospital, Clinic for Neurology, Boston, MA, United States
  • Joachim M. Baehring - Yale School of Medicine, Clinic for Neurology, New Haven, CT, United States

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocV264

doi: 10.3205/20dgnc260, urn:nbn:de:0183-20dgnc2606

Veröffentlicht: 26. Juni 2020

© 2020 Karschnia et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: Primary dural lymphoma (PDL) represents a rare subtype of primary CNS lymphomas arising from the dura mater. Population-based incidence data is scarce and clinical experience is limited. We aimed to determine relative incidence, therapeutic approaches, and survival in primary dural lymphomas.

Methods: We retrospectively searched the institutional databases of the Divisions of Neuro-Oncology at two large academic cancer centres for patients with primary CNS lymphoma (n=316). In cases with pathologically confirmed dural lymphoma and no evidence of parenchymal cerebral or systemic involvement, we collected demographic and histological information; diagnostic findings; therapeutic approaches; and outcome.

Results: We identified twenty patients treated for PDL, representing 6.3% among all patients with primary CNS lymphomas. PDL mostly arose from the cranial dura mater. The following histologies were encountered: diffuse large B-cell lymphoma (10/20 patients); marginal zone lymphoma (6/20); follicular lymphoma (2/20); undefined B-cell non-Hodgkin lymphoma (1/20); and T-cell non-Hodgkin lymphoma (1/20). On imaging studies, all patients had dural-based tumors with vivid contrast enhancement. Lesions displayed high signal on diffusion-weighted imaging (DWI)-MRI and median diffusion coefficient (ADC)-ratio was 667 ± 26 mm2/s.CSF analysis and symptoms were unspecific, and diagnosis rested upon tissue analysis. Localized (surgery; stereotactic or involved-field radiation therapy) or systemic therapeutic approaches (steroids; chemotherapy) were provided. Median overall survival was not reached after five years. Three patients were deceased at database closure due to tumor progression. Tumor resection other than biopsy positively correlated with improved overall survival (p = 0.044).

Conclusion: PDL is a rare variant of primary CNS lymphomas. Outcome may be excellent with multimodal therapeutic approaches. Aggressive surgery may form the basis for a favourable outcome in selected cases.