Burkitt-like lymphoma of the brain mimicking an intraventricular colloid cyst

1. Department of Radiology and Imaging Diagnosis, University Hospital of Santa Maria, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil. Mailing address: Dr. Felipe Welter Langer. Department of Radiology and Imaging Diagnosis, University Hospital of Santa Maria, Federal University of Santa Maria. Avenida Roraima, 1000, Camobi. Santa Maria, RS, Brazil, 97105900. E-mail: [email protected]. with high local invasion, rapid growth, and early distant metastasis unless they are excised in a timely manner. The most common locations for MPNST in neurofibromatosis patients are the extremities, head, and neck. Thoracic involvement, however, is remarkably rare, few cases having been reported. According to the size and location of the intrathoracic tumor, compressive manifestations such as pain, dyspnea, dysphagia, and superior vena cava syndrome may be the presenting manifestations, as seen in our patient, who reported dyspnea as the sole symptom related to his MPNST. The identification of MPNST in neurofibromatosis patients may be troublesome for several reasons. First, the existence of multiple benign neurofibromas may delay the identification of changes in plexiform neurofibromas. In addition, because superficial cutaneous neurofibromas do not undergo malignant transformation, MPNSTs often remain undetected until they reach a moderate size or cause compressive symptoms. Furthermore, CT and magnetic resonance imaging might not be accurate enough to differentiate benign from malignant lesions with any degree of reliability in the very early stages, although advances have been made in the area of positron emission tomography. Therefore, any suspicious lesions should generally prompt histological sampling. Although the mainstay of successful treatment of an MPNST is surgical excision after disease staging, neoadjuvant chemotherapy may be employed in order to reduce its dimensions beforehand, especially in patients with lesions surrounding vital organs. Radiotherapy might also delay recurrence, although it has not been shown to improve survival in MPNST patients. REFERENCES