Gamma Knife Radiosurgery for Large B-Cell Lymphoma with Brain Stem Metastasis.

 

Case Summary:

34 years male from Karachi, K/C of Diffuse Large B Cell Lymphoma since April 2023 presented with weakness in right limbs for 2 weeks. Patient underwent hepatic & abdominal lymph node biopsy in April 13, 2023 & also received chemotherapy in September 2023. Patient has no history of radiation. Patient is sitting on wheel chair & has 3/5 power in right limbs. MRI brain with contrast dated December 01, 2023 shows ill-defined signal intensity with linear nodular enhancement noted in left hemi pons extending into mid brain, thalamus & internal capsule could be brain deposit. PET CT scan dated December 05, 2023 shows negative post treatment FDG PET CT scan study with symmetrical normal FDG avidly bilateral cerebral hemisphere. Histopathology dated April 19, 2023 shows diffuse high grade large B Cell Lymphoma. Risks of GKSRS have been explained Written and valid consent obtained to proceed.

Follow up Comparative Study I February,2024:

Patient visited the gamma knife center for the first routine follow up presented with recent MRI brain with contrast dated January 29, 2024 shows complete resolution of the targeted lesion , no new lesion seen when compared with previous MRI brain with contrast dated December 01, 2023 consistent with good ongoing control of tumor.