(A)case of primary central nervous system lymphoma : an unusual presentation with hormonal abnormalities and good prognosis after chemo-radiotherapy

Abstract

Here, an unusual case of primary central nervous system lymphoma (PCNSL) with a suprasellar lesion involving the thalamus and hypothalamus is reported; the lesion caused diabetes insipidus (DI) and hypopituitarism. A complete type of central diabetes insipidus and hypopituitarism were diagnosed by water deprivation and vasopressin challenge test, and a combined pituitary stimulation test. After high dose methotrexate based chemotherapy and radiotherapy, the lymphoma showed complete remission. Pituitary hormones were replaced with hydrocortisone, levothyroxine and desmopressin. Though the symptoms and signs of DI and hypopituitarism have been persisted partially over the past 3 years, the hormone requirements have been decreased gradually. This case demonstrated that the endocrine abnormalities could gradually recover after the primary tumor was treated.