Rare-40. bing-neel syndrome: diagnostic & therapeutic issues

We present two cases that present both diagnostic and therapeutic issues in patients with known Waldenstrom’s Macroglobulinaemia (WM), also known as Lymphoplasmocytic Lymphoma. CASE 1: This patient had a past history of breast carcinoma and had long-standing WM found asymptomatically. She had completed chemotherapy for WM with CVP and developed numbness and gait difficulties initially attributed to vincristine. She was allergic to Rituximab. She had features of a myelopathy and MRI showed diffuse myelopathy with enhancement and oedema with leptomeningeal enhancement. ON CSF flow cytometry the WM clone noted previously was identified. She was treated with 9 cycles of high dose Methotrexate (8 gm/m2) and will be considered for Ibrutinib therapy. MRI changes were minimal but she had significant neurologic improvement and stabilisation. CASE 2: This elderly patient presented following a single drop attack and was found to have a meningeal lesion involving the falx anteriorly. It was unclear if this was related to her event. She had a long history of WM and systemic disease was under control with prior therapies. This was followed but continued to slowly increase in size, with infiltration into the surrounding parenchyma. Biopsy confirmed WM rather than meningioma. She was treated successfully with focal radiation therapy with a good response. These cases show that BNS needs to be considered and can have a varied presentation. Recent studies have shown the condition to the r...
Source: Neuro-Oncology - Category: Cancer & Oncology Authors: Tags: RARE TUMORS Source Type: research