Primary diffuse large cell lymphoma of the mandible.

Primary diffuse large cell lymphoma of the mandible is a rare form of extranodal non-Hodgkin's lymphoma (NHL). Herein we present 4 cases treated at our institution over a 5-year period and review 40 cases previously reported in the English-literature. The median age at presentation is 51 years with equal distribution between males and females. At presentation the lymphoma is usually limited to the jaw (stage IE) and the most common presenting symptoms include swelling of the jaw (58%), pain (53%), and mental dysesthesia or numbness (20%). Despite symptoms of numb chin syndrome, central nervous system (CNS) involvement at presentation has not been reported. The reported therapy of this rare diffuse large cell lymphoma presentation is very heterogeneous, however majority of patients were treated with combination of chemotherapy and radiotherapy with estimated 5-year overall survival of only 60%. Multi-center prospective clinical trials are needed to determine the optimal therapeutic approach to this rare diffuse large cell lymphoma presentation.