Primary spinal epidural mantle cell lymphoma: Case report

OBJECTIVE AND IMPORTANCE: Mantle cell lymphoma is a distinct clinicopatholo gical type of non-Hodgkin's lymphoma that often presents at an advanced sta ge, with systemic spread. Spinal involvement is uncommon and generally occu rs as part of advanced disease or generalized relapses. Primary spinal epid ural lymphoma is a rare initial manifestation of non-Hodgkin's lymphoma, an d mantle cell lymphoma with initial presentation in the spinal epidural spa ce is extremely rare, having been previously reported in only two cases. CLINICAL PRESENTATION: We report a case of a 71-year-old man who presented with increasing weakness and numbness of the legs. Magnetic resonance imagi ng revealed a spinal epidural mass in the lumbosacral region. INTERVENTION: The patient underwent a partial L4 and L5-S1 laminectomy, wit h incomplete resection of the mass for spinal decompression and tissue diag nosis. Mantle cell lymphoma was diagnosed in the pathological examination. CONCLUSION: After radiotherapy, the disease recurred with a soft-tissue mas s in the anterior maxillary area of the face. The patient underwent restagi ng and was treated with chemotherapy, with only a partial response. Mantle cell lymphoma with primary spinal epidural presentation is rare. This diagn osis can be established and other causes of spinal cord compression can be ruled out by obtaining tissue for proper histopathological examinations. Be cause of its aggressive behavior and poor prognosis, mantle cell lymphoma s hould be treated using a combined-modality approach.