{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T14:47:28Z","timestamp":1758811648725,"version":"3.41.2"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T00:00:00Z","timestamp":1706054400000},"content-version":"vor","delay-in-days":42,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Methotrexate (MTX) is a drug used for treating rheumatoid arthritis. Recently, the reported incidence of methotrexate-associated lymphoproliferative disease (MTX-LPD) has increased, especially in Japan. Extranodal involvement is observed in half of MTX-LPD cases. However, only a few spinal lesions have been reported, with none in the sacrum. Additionally, Epstein-Barr virus (EBV) infection has also been implicated in the pathogenesis of MTX-LPD. Herein, we describe the case of a 74-year-old woman with MTX-LPD in the sacral spine who complained of severe back pain and nocturnal pain. Radiographs revealed a tumour on the right wing of the sacrum and a positive EBV immunoglobulin G antibody titre. MTX-LPD was suspected based on imaging findings and a history of MTX administration. A pathological examination was performed on the CT-guided biopsy specimen. The histopathological diagnosis was MTX-LPD, and MTX was discontinued. Three months after MTX administration ended, the tumour tended to shrink, and 1 year later, significant tumour shrinkage was observed. This experience suggests that MTX-LPD can be treated by discontinuing MTX administration. Therefore, early and accurate diagnosis is required, as is avoiding unnecessary treatment such as surgery. MTX-LPD should be considered, especially in spinal origin tumours in EBV-infected patients on MTX.<\/jats:p>","DOI":"10.1093\/bjrcr\/uaae002","type":"journal-article","created":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T14:06:28Z","timestamp":1706105188000},"source":"Crossref","is-referenced-by-count":2,"title":["The first case of methotrexate-associated lymphoproliferative disorder in the sacrum: a case report"],"prefix":"10.1093","volume":"10","author":[{"given":"Yuichi","family":"Yamaguchi","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, Saga University , Saga 849-8501, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadatsugu","family":"Morimoto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, Saga University , Saga 849-8501, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Toda","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, Saga University , Saga 849-8501, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masatsugu","family":"Tsukamoto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, Saga University , Saga 849-8501, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomohito","family":"Yoshihara","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, Saga University , Saga 849-8501, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirohito","family":"Hirata","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, Saga University , Saga 849-8501, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takaomi","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, Saga University , Saga 849-8501, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaaki","family":"Mawatari","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, Saga University , Saga 849-8501, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,1,23]]},"reference":[{"issue":"11","key":"2024020116352300000_uaae002-B1","first-page":"1741","article-title":"Lymphoma developing in a patient with rheumatoid arthritis taking low dose weekly methotrexate","volume":"18","author":"Ellman","year":"1991","journal-title":"J 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