Rapid improvement of paraplegia caused by epidural involvements of Burkitt's lymphoma with chemotherapy.

Abstract:

STUDY DESIGN:Case report. OBJECTIVE:The authors present a case of atypical Burkitt's lymphoma with multiple epidural involvements. SUMMARY OF BACKGROUND DATA:Spinal cord compression in children is an emergency that requires urgent attention to minimize neurologic dysfunction. Although it is not life-threatening in most patients, cord compression can cause severe neurologic morbidity. MATERIALS AND METHODS:Because the patient showed rapid neurologic deterioration, we started chemotherapy and high-dose steroids without laminectomy or radiotherapy immediately after a tumor biopsy from the left mandible. RESULT:The combined therapies were very effective and his neurologic symptoms improved immediately. The epidural involved masses disappeared in imaging studies after the first course of chemotherapy including methylprednisolone (20 mg/kg per day for 3 consecutive days and gradually tapered off over 2 weeks), vincristine (1.5 mg/m2 per day), cyclophosphamide (2 g/m2 per day for 2 days) and pirarubicin (40 mg/m2 per day). After completing seven courses of chemotherapy, the patient is now fully ambulant. CONCLUSION:Considering the severe late effects of laminectomy and radiotherapy, chemotherapy should be considered as a first choice of treatment for spinal cord compression caused by malignant lymphoma.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Matsubara H,Watanabe K,Sakai H,Chang H,Fujino H,Higashi Y,Kobayashi M,Adachi S,Seto S,Nakahata T

doi

10.1097/01.BRS.0000105540.76773.9C

keywords:

subject

Has Abstract

pub_date

2004-01-01 00:00:00

pages

E4-6

issue

1

eissn

0362-2436

issn

1528-1159

journal_volume

29

pub_type

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