ABSTRACT
Skeletal muscle involvement in Hodgkin lymphoma is very rare. An 11-year male child presented with stage IV Hodgkin lymphoma and skeletal muscle involvement in right gluteal, piriformis and psoas muscles. He had resistant disease. He achieved remission with 3rd line chemotherapy, EPIC; and successfully underwent high dose chemotherapy with autologous stem cell rescue. The patient is well after 15 months of follow-up. Successful treatment signifies positron emission computed tomography (PET/CT) evaluation and multidisciplinary team discussions in diagnosis and management of a rare Hodgkin lymphoma presentation.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols , Hodgkin Disease/diagnostic imaging , Muscle Neoplasms/diagnostic imaging , Muscle, Skeletal/diagnostic imaging , Positron Emission Tomography Computed Tomography/methods , Bone Marrow/pathology , Child , Hematopoietic Stem Cell Transplantation , Hodgkin Disease/pathology , Humans , Male , Muscle Neoplasms/pathology , Muscle, Skeletal/pathology , Neoplasm Staging , Transplantation, Autologous , Treatment OutcomeABSTRACT
OBJECTIVE: To evaluate the frequency of bone marrow involvement with metastatic lung and bone sites in newly-diagnosed pediatric patients with Ewing sarcoma (ES). STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan, from January 2010 to October 2015. METHODOLOGY: Newly-diagnosed pediatric-age patients with ES were inducted. Ten patients were excluded because bone marrow aspiration/biopsy (BMAB) was not done. Patients'medical records were reviewed for data collection of age, diagnosis, tumor volume, bone marrow diagnosis, metastatic work-up and outcomes. RESULTS: Atotal of 139 patients with median age of 12 years were identified. The median volume of tumors was 529 ml. Eleven patients had bone marrow (BM) disease involvement. Five (45.5%) had bone metastatic disease and 1 (9%) had both pulmonary and bone metastases. Four patients (31.1%) with positive BM had primary limb disease. CONCLUSION: Ewing sarcoma patients with bone metastatic disease have a higher frequency of BM involvement. However, BM can be involved without metastatic disease. BMAB should still be considered at staging for newly diagnosed pediatric patients with localized ES.