Surgical resection is usually ineffective because of the depth of the tumour. Treatment with irradiation and corticosteroids often only produces a partial response and tumour recurs in more than 90% of patients. Median survival is 10 to 18 months in immunocompetent patients, and less in those with AIDS. The addition of IV methotrexate and folinic acid (leucovorin) may extend survival to a median of 3.5 years. If radiation is added to methotrexate, median survival time may increase beyond 4 years. However, radiation is not recommended in conjunction with methotrexate because of an increased risk of leukoencephalopathy and dementia in patients older than 60. In AIDS patients, perhaps the most important factor with respect to treatment is the use of highly active anti-retroviral therapy (HAART), which affects the CD4+ lymphocyte population and the level of immunosuppression. The optimal treatment plan for patients with<unk>  has not been determined. Combination chemotherapy and radiotherapy at least doubles survival time, but causes dementia and leukoencephalopathy in at least 50% of patients who undergo it. The most studied chemotherapeutic agent in<unk>  is methotrexate (a folate analogue that interferes with DNA repair). Methotrexate therapy in patients with<unk>  typically requires hospitalization for close monitoring and intravenous fluids. Leucovorin is often given for the duration of the therapy. Standard chemotherapeutic regimens for<unk>  such as CHOP are ineffective in<unk> , probably due to poor penetration of the agents through the blood brain barrier. Newer treatments, such as high dose chemotherapy combined with autologous stem cell transplant are proving to increase survival by years. New research to increase permeability of the blood brain barrier with NGR-hTNF followed by CHOP, produced responses in 75% cases. A phase 1 clinical trial of ibrutinib – an inhibitor of Bruton's tyrosine kinase – in 13 patients reported responses in 10 (77%). Five of the responses were complete.
Primary central nervous system lymphoma
Malignant multiple sclerosis
Lymphocytic meningoradiculitis
Leptomeningeal cancer
Brainstem glioma
Brain metastasis
Central nervous system cavernous hemangioma
Autoimmune encephalitis