Okano Rintaro, Suzuki Kohei, Nakano Yoshiteru, Yamamoto Junkoh
Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Fukuoka 807-8555, Japan.
Mol Clin Oncol. 2021 May;14(5):95. doi: 10.3892/mco.2021.2257. Epub 2021 Mar 12.
Primary central nervous system lymphoma (PCNSL) is a rare intracranial neoplasm in older adults. Tumor-associated parkinsonism (TAP) in PCNSL is extremely rare, and its clinical features are unclear. The present report describes the case of a 75-year-old man who presented with parkinsonism due to multiple hyperintense lesions in the thalamus and periventricular white matter as visualized by magnetic resonance imaging (MRI). Due to the rapid progression of parkinsonism and lesion enlargement, the patient underwent stereotaxic biopsy. Subsequently, his condition was diagnosed as TAP in PCNSL at 2 months after onset. The patient completely recovered after treatment and experienced no recurrence of TAP for 8 months. Although it is difficult to distinguish TAP from vascular parkinsonism (VP) at initial consultation, the early diagnosis of PCNSL is important for improving prognosis. In the case of rapidly progressing parkinsonism, one should suspect the possibility of TAP associated with early-stage PCNSL. Early treatment improves the chances of remission and decreases the possibility of recurrence.
原发性中枢神经系统淋巴瘤（PCNSL）是老年人中一种罕见的颅内肿瘤。PCNSL相关的肿瘤性帕金森综合征（TAP）极为罕见，其临床特征尚不清楚。本报告描述了一名75岁男性的病例，该患者因磁共振成像（MRI）显示丘脑和脑室周围白质多发高信号病变而出现帕金森综合征。由于帕金森综合征迅速进展且病变扩大，患者接受了立体定向活检。随后，在发病2个月后其病情被诊断为PCNSL相关的TAP。患者经治疗后完全康复，且TAP在8个月内未复发。尽管在初次会诊时很难将TAP与血管性帕金森综合征（VP）区分开来，但PCNSL的早期诊断对于改善预后很重要。对于迅速进展的帕金森综合征，应怀疑与早期PCNSL相关的TAP的可能性。早期治疗可提高缓解机会并降低复发可能性。
