Hypothalamic relapse of a cardiac large B-cell lymphoma presenting with memory loss, confabulation, alexia-agraphia, apathy, hypersomnia, appetite disturbances and diabetes insipidus

Natalia Ospina-Garciá, Gustavo C. Román, Belén Pascual, Mary R. Schwartz, Hector Alejandro Preti

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

A 37-year-old Hispanic man with a right atrial intracardiac mass diagnosed as diffuse large B-cell lymphoma (DLBCL) was successfully treated with surgery and chemotherapy. During 4 years, several total-body positron emission tomography and MRI scans showed no extracardiac lymphoma. On year 5 after the cardiac surgery, patient presented with sleepiness, hyperphagia, memory loss, confabulation, dementia and diabetes insipidus. Brain MRI showed a single hypothalamic recurrence of the original lymphoma that responded to high-dose methotrexate treatment. Correction of diabetes insipidus improved alertness but amnesia and cognitive deficits persisted, including incapacity to read and write. This case illustrates two unusual locations of DLBCL: Primary cardiac lymphoma and hypothalamus. We emphasise the importance of third ventricle tumours as causing amnesia, confabulation, behavioural changes, alexia-agraphia, endocrine disorders and alterations of the circadian rhythm of wakefulness-sleep secondary to lesions of specific hypothalamic nuclei and disruption of hypothalamic-thalamic circuits.

Original languageEnglish (US)
Article number217700
JournalBMJ Case Reports
Volume2018
DOIs
StatePublished - 2018

Keywords

  • cancer intervention
  • memory disorders
  • neuroendocrinology
  • neurooncology
  • sleep disorders (neurology)

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint Dive into the research topics of 'Hypothalamic relapse of a cardiac large B-cell lymphoma presenting with memory loss, confabulation, alexia-agraphia, apathy, hypersomnia, appetite disturbances and diabetes insipidus'. Together they form a unique fingerprint.

Cite this