Silent clinical presentation of cerebellar lymphoma

Background: Primary central nervous system lymphoma is a rare condition, accounting for 2–6% of all primary brain neoplasms and 1–2% of all non-Hodgkin lymphomas, and it usually presents as a solitary lesion. Cerebellar involvement is present in only 9% of cases. Objective: The main aim of this paper is to present a clinical case of Non-Hodgkin Lymphoma localised in cerebellum, its clinical presentation, diagnosis, treatment and follow-up. Case report: A 25-year old female patient presents as headache, nausea and ataxia. First CT scan reveals Non-Hodkgin Lymphoma in cerebellar region (picture below), which was treated surgically and followed by chemotherapy and whole-brain radiotherapy, which led to 11 yearlong remission period. After remission period three relapses appeared in 10-year long period, followed by chemotherapy and stereotactic radiotherapy, which led to permanent cancer remission, but also permanent neurological deficit and quality of life impairment remained a long-term milestone in cancer rehabilitation.  Conclusion: This rare localisation of common disease presents a large diagnostic challenge for medical practice because of its long asymptomatic period, but also after-treatment follow-up must be carefully selected, in order to rationalise therapy option oriented to long-term quality of life preservation.