Progressive multifocal leukoencephalopathy mimicking cerebral metastases in a patient treated for nasopharyngeal carcinoma

BJMO - volume 10, issue 7, november 2016

K. Oualla MD, M. Aoun MD, M. Lemort MD, A. Harrouk MD, S. Latifyan MD, A. Awada MD, PhD, A. Georgala MD


Progressive multifocal leukoencephalopathy is a rare demyelinating condition caused by reactivated JC polyomavirus. This disease occurs mainly in the context of immunodeficiency, usually from human immunodeficiency virus.We report a case of 67 years old patient, treated for metastatic nasopharyngeal epidermoid carcinoma with three lines of chemotherapy, admitted for deterioration of performance status and neurological symptoms represented by agitation, cognitive decline complicated by loss of consciousness, after receiving three cycles of carboplatin-docetaxel. Cerebral imaging had strongly suspected brain metastases given to the context of metastatic neoplasm in progression but cerebrospinal fluid was positive for JC-BK Polyomavirus. Unfortunately, evolution was marked by rapid clinical deterioration leading to death. We report this case in order to underline the rarity of this disease, clinico-radiological features, especially misleading appearance with cerebral metastases, risk factors and prognosis.

(BELG J MED ONCOL 2016;10(7):276–280)

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