Primary pediatric mid-brain lymphoma: Report of a rare pediatric tumor in a rare location

Abstract

Primary central nervous system lymphoma (PCNSL) is a rare disease in pediatric age group. A thirteen-year-old male child presented with complaints of headache for six months, vomiting and diplopia for three days. Magnetic resonance imaging of the brain showed a single lesion of 1.7 cm × 1.6 cm × 1.6 cm in the mid brain and tectum. He underwent a gross total resection of the tumor. The histopathological evaluation revealed B cell high grade non Hodgkin lymphoma. The patient was treated with High dose methotrexate and cranio spinal radiation. The patient was alive without disease 12 mo after completion of treatment. This case highlights importance of keeping PCNSL as differential in brain stem lesions of pediatric patients also. Radiation and chemotherapy remains the most important treatment for such patients.

Keywords: Primary; Midbrain; Lymphoma; Paediatric

Core tip: Primary central nervous system lymphoma (PCNSL) in pediatric population is an uncommon disease. In addition location in the brainstem is far less common. We are reporting a rare case of PCNSL in the brain stem location in a 13-year-old patient. Brain stem lesions are not generally considered for lymphoma. This case highlights importance of keeping brainstem lymphoma as a differential.