A rare case of vomiting: fourth ventricular B-cell lymphoma

We document the case of a 69-year-old man presenting with 6 weeks of intractable vomiting. Magnetic Resonance Imaging showed a homogenously enhancing mass in the caudal fourth ventricle. Surgical exploration and biopsy was performed and pathological examination demonstrated a high-grade B-cell lymphoma. The lesion was a primary tumour in an immuno-competent patient. Despite the increasing incidence of primary central nervous system lymphomas this is believed to be only the third ever case to have occurred at this rare site. We suggest that primary B-cell lymphoma should be considered with homogenous lesions of the fourth ventricle.