Skip to main content

An instructive false diagnosis: Steroid-induced complete remission of a CNS tumor — probably lymphoma

Neurosurgical Review volume 21, pages 48–51 (1998)Cite this article

Abstract

In recent years the incidence of primary cerebral lymphomas has increased. Diagnosis by imaging techniques (CCT, angiography MRT) and stereotactic biopsy are considered as reliable diagnostic tools. Therapeutically a combination of radio-, steroid- and chemotherapy is recommended. We report a case of space-occupying CNS lesion in which the radiopaque enhancing process completely disappeared after biopsy and steroid therapy. A year later the tumor recurred on the other side and again regressed after steroid therapy. The first biopsy showed signs of a papillar tumor, so a choroid plexus papilloma was suspected. On examination of the treatment history, however, this diagnosis had to be revised. A primary CNS lymphoma seems most probable. The phenomenon of a tumor remission under steroid administration and the problems related to the differential diagnosis are discussed.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

References

  1. Abe M, K Tabuchi, M Takagi, S Matsumoto, T Shimokama, T Kishikawa: Spontaneous resolution of multiple hemangiomas of the brain. J Neurosurg 73 (1990) 448–452

    Google Scholar 

  2. Enzinger FM, SW Weiss (eds): Soft tissue tumors. CV Mosby, St Louis 1988

    Google Scholar 

  3. Fric M, A Hartmann, HU Klehr, U Pfeifer, C Herberhold: Regression zerebraler Posttransplantationslymphome unter Cyclosporin-A-Reduktion. Klin Wochenschr 68 (1990) 1189–1194

    Google Scholar 

  4. Hara A, Y Kaku, Y Nishimura, N Sakai, H Yamada: Remission of recurrent primary intracranial malignant lymphoma after high-dose intra-arterial corticosteroid administration and intra-arterial chemotherapy — case report. Neurol Med Chir 34 (1994) 700–703

    Google Scholar 

  5. Hellwig D, BL Bauer, E List-Hellwig, C Rossberg, HD Menell: Das primär zerebrale Lymphom (PCL). Zentralbl Neurochir 54 (1993) 99–109

    Google Scholar 

  6. Holtas S, U Nyman, S Cronquist: Computed tomography of malignant lymphoma of the brain. Neuroradiology 26 (1984) 33–38

    Google Scholar 

  7. Homo-Delarche F: Glucocorticoid receptors and steroid sensitivity in normal and neoplastic human lymphoid tissues, A review. Cancer Res 44 (1984) 431–437

    Google Scholar 

  8. Jack CR, BP O'Neill, PM Banks, DF Reese: Central nervous system lymphoma: Histologic types and CT appearance. Radiology 167 (1988) 211–215

    Google Scholar 

  9. Kojo N, T Tokutomi, G Eguchi, S Takagi, T Matsumoto Y Sasaguri, M Shigemori: Spontaneous regression of intracranial malignant lymphoma. Neurol Med Chir 28 (1988) 498–503

    Google Scholar 

  10. Murray K, L Kun, J Cox: Primary malignant lymphoma of the central nervous system. Results of treatment of 11 cases and review of the literature. J Neurosurg 65 (1986) 600–607

    Google Scholar 

  11. Nakasu S, Y Nakasu, M Kidooka, J Handa: Transient spontaneous regression of mass effect with glioma. Acta Neurochirurgica 74 (1987) 53–56

    Google Scholar 

  12. Neuwelt EA, EP Frenkel, MK Gumerlock, R Braziel, B Dan, SA Hill: Developments in the diagnosis and treatment of primary CNS lymphoma. Cancer 58 (1986) 1609–1620

    Google Scholar 

  13. Rainov NG, W Burkert: Spontaneous shrinking of a macroprolactinoma. Neurochirurgia 36 (1993) 17–19

    Google Scholar 

  14. Rampen FHJ, J Melier: Metastatic melanoma of the brain after spontaneous regression of the primary. Acta Neurol Scand 72 (1985) 222–224

    Google Scholar 

  15. Singh A, RJ Strobos, BM Singh, AB Rothballer, V Reddy, S Puliic, TP Poon: Steroid-induced remissions in CNS lymphoma. Neurology 32 (1982) 1267–1271

    Google Scholar 

  16. Sugita Y, M Shigemori, T Yuge, O Iryo, S Kuramoto, Y Nakamura, M Morimatsu: Spontaneous regression of primary intracranial lymphoma. Surg Neurol 30 (1988) 148–152

    Google Scholar 

  17. Tallroth K, K Katevuo, L Holsti, U Anderson: Angiography and computed tomography in the diagnosis of primary lymphoma of the brain. Clin Radiol 32 (1981) 383–388

    Google Scholar 

  18. Vaquero J, R Martinez, R Lopez: Primary cerebral lymphoma: the “ghost tumour”. Case report. J Neurosurg 60 (1984) 174–176

    Google Scholar 

  19. Vaugh TC, AF Haney, RH Wiege, RS Kramer, CB Hammond: Spontaneous regression of prolactin-producing pituitary adenomas. Am J Obstet Gynecol 136 (1980) 980–982.

    Google Scholar 

  20. Weingarten KL, RD Zimmermann, NE Leeds: Spontaneous regression of intracerebral lymphoma. Radiology 149 (1983) 721–724

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, University Erlangen-Nürnberg, Schwabachanlage 6, D-91054, Erlangen, Germany

    Josef G. Heckmann, Achim Druschky & Bernhard Neundörfer

  2. Department of Neurosurgery, Hospital “Hohe Warte”, Bayreuth, Germany

    Jürgen Bockhorn

  3. Department of Pathology, Bayreuth Teaching Hospital, Bayreuth, Germany

    Manfred Stolte

Authors
  1. Josef G. Heckmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jürgen Bockhorn
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Manfred Stolte
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Achim Druschky
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Bernhard Neundörfer
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Heckmann, J.G., Bockhorn, J., Stolte, M. et al. An instructive false diagnosis: Steroid-induced complete remission of a CNS tumor — probably lymphoma. Neurosurg. Rev. 21, 48–51 (1998). https://doi.org/10.1007/BF01111485

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01111485

Keywords

  • Choroid plexus papilloma
  • lymphoma
  • neoplasma regression
  • steroids/tu (therapeutic use)