Rare case of distal tibial Diffuse Large B-cell Lymphoma (DLBCL) in a diabetic with charcot neuroarthropathy

Abstract

Purpose: Diffuse large b-cell lymphoma (DLBCL) accounts for approximately 40% of all cases of non-Hodgkin's lymphoma (Alizadeh). Primary bone lymphoma is a rare and peculiar extranodal presentation of non-Hodgkin's lymphoma. The most frequent site of PLB is the femur, followed by the pelvis, and tibia. The purpose of this case report is to present a rare form of DLBCL in the distal tibia of a patient undergoing Charcot reconstruction in order to bring awareness of the disease and report on the surgical management of DLBCL in the lower extremity. Case study: One diabetic male with Charcot neuroarthropathy found to have concurrent tibial DLBCL who underwent primary surgical resection followed by 6 months of chemotherapy with resolution of the lymphoma. Procedures: Resection of distal tibia, ex-fix application, medial column fusion, ankle fusion, TTC fusion Results: Diabetic male in remission with a stable, plantigrade foot after surgical resection of lymphoma followed by Charcot reconstruction. Analysis & discussions: This case is a rare presentation of PLB given the location and conjunction with Charcot. To our knowledge, there is no other report demonstrating these two destructive bone conditions affecting the same limb. Patients with PLB frequently lack systemic symptoms, conversely, they commonly complain of local symptoms, such as pain, swelling and pathological fractures, which are very common symptoms associated with Charcot.