Primary central nervous system Burkitt lymphoma in a 38-year-old immunocompetent woman: A case report.

RATIONALE: Primary central nervous system Burkitt lymphoma (PCNSBL) is a rare and aggressive malignancy, particularly challenging to diagnose in immunocompetent individuals due to its nonspecific presentation.

PATIENT CONCERNS: A 38-year-old immunocompetent woman presented with a 1-week history of progressively severe headaches in the left frontotemporal region, without systemic symptoms or significant laboratory abnormalities.

DIAGNOSES: Advanced magnetic resonance imaging revealed a nodular lesion in the left frontal area, initially diagnosed as meningioma. Postsurgical histopathological analysis confirmed the diagnosis of Burkitt lymphoma, characterized by diffuse infiltration of medium-sized lymphocytes, a high MIB1 proliferation index, and Myc gene rearrangement.

INTERVENTIONS: The patient underwent complete surgical resection of the tumor and a 5-cycle chemotherapy regimen based on high-dose methotrexate, without the need for radiotherapy due to the localized nature of the tumor and complete surgical removal.

OUTCOMES: Postoperatively, the patient's headaches resolved, and no evidence of tumor recurrence was observed on magnetic resonance imaging after 11 months of follow-up. Additional examinations, including fluorodeoxyglucose-18-positron emission computed tomography, bone marrow biopsy, and cerebrospinal fluid cytology, confirmed the absence of systemic involvement.

LESSONS: This case highlights the importance of considering PCNSBL in the differential diagnosis of brain tumors, even in immunocompetent patients. Early diagnosis and a tailored chemotherapy regimen can lead to favorable treatment outcomes, emphasizing the need for a multimodality approach in managing PCNSBL.