To report a rare case of diffuse large B-cell lymphoma (DLBCL) presenting as a scalp tumor with extensive skull destruction and suspected central nervous system (CNS) involvement, highlighting its clinical implications.
Key Findings:
Histopathological examination revealed diffuse proliferation of large atypical B lymphocytes consistent with a non-GCB phenotype of DLBCL.
Imaging studies demonstrated a large scalp mass with marked osteolytic skull destruction and extension into the superior sagittal sinus.
Immunohistochemical analysis showed expression of RANKL in tumor cells.
The tumor showed marked regression and improvement of neurological symptoms after treatment.
Systemic evaluation revealed multi-organ involvement, including bone marrow infiltration.
Interpretation:
The case highlights a rare presentation of DLBCL with skull destruction and suspected CNS involvement, suggesting the importance of early biopsy and systemic evaluation of cutaneous lesions to guide treatment.
Limitations:
The primary site of DLBCL could not be definitively determined.
Follow-up duration was limited to 6 months.
Potential biases in case selection and reporting may affect generalizability.
Conclusion:
The findings suggest that tumor-associated RANKL expression may be linked to the osteolytic features observed in this case, emphasizing its potential role in treatment strategies.
With recent data that RAS inhibition can improve survival in metastatic pancreatic cancer, the optimization of these agents has become a research priority. Minh Than, MD, PhD, a clinical and research ...
