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Case report
Primary spinal epidural lymphoma: a rare entity with an ambiguous management
  1. João Páscoa Pinheiro1,
  2. Joana Rato1,
  3. Olinda Rebelo2 and
  4. Gonçalo Costa1
  1. 1Department of Neurosurgery, Coimbra University Hospital Centre, Coimbra, Portugal
  2. 2Department of Neurology, Coimbra University Hospital Centre, Coimbra, Portugal
  1. Correspondence to Dr João Páscoa Pinheiro; jpascoapinheiro{at}


Lymphomas are malignant lymphoid tumours arising from lymphocytic cells. They usually develop in the lymphoid tissues and can spread to other organs; however, primary extra-nodal locations such as the spinal epidural space are less common. The authors report the case of a primary diffuse large B-cell lymphoma of the thoracic spine in a 65-year-old man, who presented to the emergency department with signs of upper motor neuron lesion. The patient underwent surgery in order to decompress the spinal cord. The treatment was concluded with six cycles of chemotherapy with methotrexate, rituximab, cyclophosphamide, vincristine and prednisone followed by radiotherapy. At the 24-month follow-up, no signs of epidural lesion or bone contrast enhancement were observed in thoracic spine MRI. Surgical decompression is recommended in patients with signs of spinal cord injury in order to prevent irreversible neurological damage and is related to high rates of disease-free survival.

  • neurosurgery
  • surgical oncology

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  • Contributors JPP and JR approached the patient in the emergency and during hospitalisation. They had preform a literature revision about spine lymphomas. They had preformed the original draft. OR and GC took the management and coordination responsibility for the research activity planning and execution. They had reviewed the original draft and corrected grammatical errors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.