Cerebral involvement as the initial manifestation of chronic lymphocytic leukaemia

Abstract

A 53-year-old man presented with focal jacksonian seizures that were due to cerebral tumour manifestations. Stereotactic biopsy revealed infiltration by lymphocytes compatible with the diagnosis of chronic lymphocytic leukaemia (CLL). Simultaneously, Binet stage II CLL with bone marrow infiltration was diagnosed. Cranial radiotherapy with 36 Gy was performed. One year after diagnosis, the patient is in stable disease. Cerebral involvement is rare but may occur in early CLL. Cranial radiotherapy may lead to lasting remission. In case of spinal fluid involvement intrathecal chemotherapy is recommended.