Cauda equina syndrome in a patient with human immunodeficiency virus and secondary central nervous system lymphoma: a case report

J Med Case Rep. 2023 Nov 15;17(1):476. doi: 10.1186/s13256-023-04212-5.

Abstract

Background: Secondary central nervous system lymphoma (SCNSL) is a known complication of immunocompromised patients with most cases involving the brain parenchyma. Reports of cauda equina syndrome (CES) caused by SCNSL are exceedingly scarce as involvement of this anatomical region is extremely uncommon.

Case presentation: We report a case of a 46-years-old, African, female patient with human immunodeficiency virus (HIV) who developed CES in the context of SCNSL. There were no blasts present in the peripheral blood smear. We provide a review of the literature, discussion of the clinical evolution of this patient and the radiological/histopathological findings. The patient ultimately responded well to induction chemotherapy and high dose methotrexate.

Conclusion: This case report demonstrates that CES, while a rare occurrence in this clinical context, should be considered in at-risk patients especially those presenting with abnormal neurological findings. Prompt recognition may prevent permanent neurological injury and obviate the need for more invasive therapeutic interventions.

Keywords: Cauda equina syndrome; HIV; Immunocompromised; Lymphoma.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Cauda Equina Syndrome* / diagnostic imaging
  • Cauda Equina Syndrome* / etiology
  • Central Nervous System
  • Female
  • HIV
  • Humans
  • Lymphoma*
  • Middle Aged