Hypothalamic relapse of a cardiac large B-cell lymphoma presenting with memory loss, confabulation, alexia-agraphia, apathy, hypersomnia, appetite disturbances and diabetes insipidus.
BMJ Case Rep
; 20182018 Aug 27.
Article
en En
| MEDLINE
| ID: mdl-30150329
ABSTRACT
A 37-year-old Hispanic man with a right atrial intracardiac mass diagnosed as diffuse large B-cell lymphoma (DLBCL) was successfully treated with surgery and chemotherapy. During 4 years, several total-body positron emission tomography and MRI scans showed no extracardiac lymphoma. On year 5 after the cardiac surgery, patient presented with sleepiness, hyperphagia, memory loss, confabulation, dementia and diabetes insipidus. Brain MRI showed a single hypothalamic recurrence of the original lymphoma that responded to high-dose methotrexate treatment. Correction of diabetes insipidus improved alertness but amnesia and cognitive deficits persisted, including incapacity to read and write. This case illustrates two unusual locations of DLBCL primary cardiac lymphoma and hypothalamus. We emphasise the importance of third ventricle tumours as causing amnesia, confabulation, behavioural changes, alexia-agraphia, endocrine disorders and alterations of the circadian rhythm of wakefulness-sleep secondary to lesions of specific hypothalamic nuclei and disruption of hypothalamic-thalamic circuits.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias del Ventrículo Cerebral
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Metotrexato
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Linfoma de Células B Grandes Difuso
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Tercer Ventrículo
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Neoplasias Cardíacas
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Recurrencia Local de Neoplasia
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Antimetabolitos Antineoplásicos
Tipo de estudio:
Etiology_studies
Límite:
Adult
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Humans
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Male
Idioma:
En
Revista:
BMJ Case Rep
Año:
2018
Tipo del documento:
Article
País de afiliación:
Colombia