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Steroid-induced delayed diagnosis of primary vitreoretinal lymphoma with ghost brain tumor: A case report
Primary vitreoretinal lymphoma is a great masquerader and provides a diagnostic challenge. It is most frequently misdiagnosed as a chronic uveitis. Steroid treatment for presumed uveitis can interfere with the correct diagnosis of vitreoretinal lymphoma. Herein, we present a case of primary vitreore...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Lippincott Williams & Wilkins
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9302244/ https://www.ncbi.nlm.nih.gov/pubmed/35866822 http://dx.doi.org/10.1097/MD.0000000000029637 |
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author | Kau, Hui-Chuan Wang, Cheng-Jen Tsai, Chieh-Chih |
author_facet | Kau, Hui-Chuan Wang, Cheng-Jen Tsai, Chieh-Chih |
author_sort | Kau, Hui-Chuan |
collection | PubMed |
description | Primary vitreoretinal lymphoma is a great masquerader and provides a diagnostic challenge. It is most frequently misdiagnosed as a chronic uveitis. Steroid treatment for presumed uveitis can interfere with the correct diagnosis of vitreoretinal lymphoma. Herein, we present a case of primary vitreoretinal lymphoma in which the correct diagnosis was delayed by short-term steroids until 2 years later. PATIENT CONCERNS: A 45-year-old woman presented with floaters and blurred vision in her right eye for 3 months. An ocular examination revealed dense vitreous cells. Three months later, she developed headache and suicidal ideation after taking a 3-week medication of oral steroid medication from another eye clinic. Brain magnetic resonance imaging revealed a tumor involving the corpus callosum and periventricular region. INTERVENTIONS: Vitreous biopsy and repeated brain biopsies were carried out for the patient. DIAGNOSIS: A brain biopsy was performed for the first time, and a vitreous biopsy was performed when steroid medication was suspended for 20 and 41 days, respectively. Both biopsies were negative for the presence of malignant cells. Follow-up magnetic resonance imaging revealed complete remission of the brain tumor. Two years later, the tumor recurred in the optic chiasm. Diffuse large B-cell lymphoma was confirmed by a second brain biopsy. OUTCOME: The patient had complete tumor remission after receiving brain radiation therapy and chemotherapy. LESSONS: Vitreoretinal lymphoma is difficult to diagnose owing to its rarity, masquerading presentation, and steroid-induced apoptosis of lymphoma cells. Physicians should consider vitreoretinal lymphoma as an important differential diagnosis in patients presenting with chronic uveitis and use steroids cautiously before making a definitive diagnosis. |
format | Online Article Text |
id | pubmed-9302244 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-93022442022-08-03 Steroid-induced delayed diagnosis of primary vitreoretinal lymphoma with ghost brain tumor: A case report Kau, Hui-Chuan Wang, Cheng-Jen Tsai, Chieh-Chih Medicine (Baltimore) Research Article Primary vitreoretinal lymphoma is a great masquerader and provides a diagnostic challenge. It is most frequently misdiagnosed as a chronic uveitis. Steroid treatment for presumed uveitis can interfere with the correct diagnosis of vitreoretinal lymphoma. Herein, we present a case of primary vitreoretinal lymphoma in which the correct diagnosis was delayed by short-term steroids until 2 years later. PATIENT CONCERNS: A 45-year-old woman presented with floaters and blurred vision in her right eye for 3 months. An ocular examination revealed dense vitreous cells. Three months later, she developed headache and suicidal ideation after taking a 3-week medication of oral steroid medication from another eye clinic. Brain magnetic resonance imaging revealed a tumor involving the corpus callosum and periventricular region. INTERVENTIONS: Vitreous biopsy and repeated brain biopsies were carried out for the patient. DIAGNOSIS: A brain biopsy was performed for the first time, and a vitreous biopsy was performed when steroid medication was suspended for 20 and 41 days, respectively. Both biopsies were negative for the presence of malignant cells. Follow-up magnetic resonance imaging revealed complete remission of the brain tumor. Two years later, the tumor recurred in the optic chiasm. Diffuse large B-cell lymphoma was confirmed by a second brain biopsy. OUTCOME: The patient had complete tumor remission after receiving brain radiation therapy and chemotherapy. LESSONS: Vitreoretinal lymphoma is difficult to diagnose owing to its rarity, masquerading presentation, and steroid-induced apoptosis of lymphoma cells. Physicians should consider vitreoretinal lymphoma as an important differential diagnosis in patients presenting with chronic uveitis and use steroids cautiously before making a definitive diagnosis. Lippincott Williams & Wilkins 2022-07-22 /pmc/articles/PMC9302244/ /pubmed/35866822 http://dx.doi.org/10.1097/MD.0000000000029637 Text en Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Kau, Hui-Chuan Wang, Cheng-Jen Tsai, Chieh-Chih Steroid-induced delayed diagnosis of primary vitreoretinal lymphoma with ghost brain tumor: A case report |
title | Steroid-induced delayed diagnosis of primary vitreoretinal lymphoma with ghost brain tumor: A case report |
title_full | Steroid-induced delayed diagnosis of primary vitreoretinal lymphoma with ghost brain tumor: A case report |
title_fullStr | Steroid-induced delayed diagnosis of primary vitreoretinal lymphoma with ghost brain tumor: A case report |
title_full_unstemmed | Steroid-induced delayed diagnosis of primary vitreoretinal lymphoma with ghost brain tumor: A case report |
title_short | Steroid-induced delayed diagnosis of primary vitreoretinal lymphoma with ghost brain tumor: A case report |
title_sort | steroid-induced delayed diagnosis of primary vitreoretinal lymphoma with ghost brain tumor: a case report |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9302244/ https://www.ncbi.nlm.nih.gov/pubmed/35866822 http://dx.doi.org/10.1097/MD.0000000000029637 |
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