Central nervous system involvement in mycosis fungoides. Diagnosis, treatment and literature review

A 58-year-old man with mycosis fungoides developed headache, back pain, and dorsal column signs. A diagnosis of central nervous system (CNS) involvement by mycosis fungoides was made on examination of his spinal fluid. In this patient, cranial and local radiotherapy and aggressive treatment with intrathecal methotrexate cleared the leukemic cells from his CNS, and maintenance therapy with intrathecal methotrexate has resulted in an 18-month remission.