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Case Report

Cancer Research Frontiers. 2016 Feb; 2(1): 55-59. doi: 10.17980/2016.55

Progressive motor polyradiculopathy and myelopathy associated with lymphoma and intrathecal methotrexate treatment, a case report and systemic review

Raja Sawaya1, Ali Bazarbachi2, Roula Hourani3.

 

1 Department of Neurology

2 Department of Internal Medicine, division of Hematology-Oncology

3 Department of Diagnostic Radiology

American University Medical Center, Beirut, Lebanon.

 

*Corresponding author: Raja A. Sawaya, MD, Professor of Neurology, Director Clinical Neurophysiology Laboratory, American University Medical Center. P.O.Box: 113 – 6044 / C-27, Beirut, Lebanon. Tel: 961-1-350 000; Fax: 961-1-744 464; Email: rs01@aub.edu.lb

Citation: Raja Sawaya, et al. Progressive motor polyradiculopathy and myelopathy associated with lymphoma and intrathecal methotrexate treatment, a case report and systemic review. Cancer Research Frontiers. 2016 Feb; 2(1): 55-59. doi: 10.17980/2016.55

Copyright: @ 2016 Raja Sawaya, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Competing Interests: The authors declare no competing financial interests.

Received Oct 19, 2015; Revised Dec 10, 2015; Accepted Jan 27, 2015. Published Feb 11, 2016

 

Abstract:

We report a patient with Burkitt’s lymphoma involving the liver and retroperitoneal lymph nodes who developed acute, progressive, quadriplegia associated with sphincter dysfunctions and an ascending sensory level after the 2nd dose of intrathecal methotrexate. The motor deficits and the spinal dysfunction persisted in spite of discontinuation of the methotrexate, as well as treatments with intrathecal steroids, pulse intravenous steroids, and intravenous immunoglobulin. The status of the lymphoma was improving on systemic chemotherapy. Whether the progressive motor neuropathy and progressive myelopathy are a toxicity of intrathecal methotrexate or a paraneoplastic phenomenon is a matter of debate.

Key words: Lymphoma, intrathecal chemotherapy, methotrexate, toxicity, paraneoplastic.

 

 

 

 

 

 

 

 

 

 

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