Abstract
Introduction: Primary central nervous system (CNS) lymphomas constitute approximately less than 2% of all intracranial neoplasms. It is rarely developed in the pituitary gland. We demonstrate a case in which a patient with diffuse B-cell type lymphoma has been treated with surgical removal followed by chemotherapy. Materials and Methods: A 45-year-old man presented with 2-week history of headache and visual disturbance. He also complained of ocular pain and polydipsia. Brain magnetic resonance (MR) images revealed intrasellar mass extending into the left cavernous sinus with encasement of internal carotid artery. Another lesions were found in the pituitary stalk, suprasellar region, and the left thalamus. Results: He underwent tumor removal via trans-sphenoidal approach. Pathological findings were consistent with diffuse large B-cell lymphoma. The postoperative course was uneventful, and he discharged himself without further management. A month later, clinical symptoms were aggravated, and then, he took chemotherapy (vincristine+procarbazine+leukovorin) with Methotrexate (MTX). However, he developed acute hypernatremia due to diabetes insipidus. His mental status was deteriorated, and eventually he was expired. CONCLUSION: Primary CNS lymphomas should be differentiated from pituitary adenomas, metastatic tumors, and infectious condition. Prompt diagnosis and intervention are essential for favorable outcome in patients with malignant lymphomas.