PMC9810803_01
(A,B) Abdominal computed tomography (CT) scan; (C,D) spine magnetic resonance imaging (MRI); (E,F) MRI of the hip joint before and after treatment. (A,C,E) Skeletal lesions with osteolysis in the femoral head, T8, and L4-L5 before local radiotherapy. (B,D,F) Osteolytic lesions diminished after local radiotherapy and high-dose methotrexate (HD-MTX) treatment. The yellow arrows represent the location of the lesion.
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F1
A spine MRI revealed an abnormal signal in T8 and L5, and a hip MRI revealed an abnormal signal in the femoral head (Figure 1).
Follow-up fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) after high-dose methotrexate (HD-MTX) showed complete metabolic response with the spine. The patient has maintained complete remission for 10 years after the initial treatment.
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F2
The efficacy evaluation showed complete remission during later follow-ups (Figure 2).
Treatment timeline of the patient with PBL.
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F3
The treatment process of this case is shown in Figure 3.