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• Vol.64 No.5
• CLINICA NEUROL, 64: 349−355, 2024
• Vol.64 No.5 contents

Case Report

Primary central nervous system lymphoma presenting as a unilateral internal auditory canal lesion: a case report

Rie Tohge, M.D., Ph.D.^1）, Masaaki Iwase, M.D., Ph.D.^2） and Takayuki Kondo, M.D., Ph.D.^1）

¹⁾ Department of Neurology, Kansai Medical University Medical Center
²⁾ Department of Neurosurgery, Kansai Medical University Medical Center

A 61-year-old man with right hearing loss and staggering for seven months was diagnosed with sudden deafness although previous evaluation with MRI indicated minor abnormal findings. During follow-up, he developed hypogeusia, right facial nerve palsy, pain in right mandible, right-sided temporal pain, and cerebellar ataxia. Cerebrospinal fluid examination at admission revealed reduced glucose concentration and elevated soluble interleukin-2 receptor (sIL-2R) level, whereas serum sIL-2R level was within the normal range. Brain MRI showed a swollen contrast-enhanced lesion extending from the right internal auditory canal to the middle cerebellar peduncle. Gallium-67 (67Ga) single-photon emission-computed tomography-computed tomography (SPECT-CT) revealed abnormal accumulation at the lesion site. Pathologic analysis of the tumor after resection led to the diagnosis of primary central nervous system lymphoma. In the present case, the MRI and 67Ga SPECT-CT characteristics were distinct from those of vestibular schwannoma. In addition, elevation of sIL-2R in the cerebrospinal fluid but not in serum was useful for differential diagnosis.
Full Text of this Article in Japanese PDF (3549K)

(CLINICA NEUROL, 64: 349−355, 2024)
key words: malignant lymphoma, tumors in the internal auditory canal, vestibular schwannoma, sudden deafness

(Received: 26-Oct-23)