RESUMEN
Anaplastic large cell lymphoma (ALCL) is a rare tumor comprising around 10-15% of childhood lymphomas. We describe the case of a female who initially presented with localized skin disease associated with an insect bite. However, she subsequently relapsed with widespread systemic ALK-positive ALCL that included lymphoma deposits in the myocardium, a very rare manifestation. Her disease responded well to chemotherapy but she later developed a fatal relapse in the CNS. We also present data on an immune response to ALK, demonstrating a fluctuation in the levels of circulating antibodies to ALK corresponding to the different phases of her illness.
Asunto(s)
Neoplasias del Sistema Nervioso Central/patología , Neoplasias Cardíacas/patología , Linfoma Anaplásico de Células Grandes/patología , Neoplasias Cutáneas/patología , Adolescente , Quinasa de Linfoma Anaplásico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias del Sistema Nervioso Central/tratamiento farmacológico , Neoplasias del Sistema Nervioso Central/genética , Progresión de la Enfermedad , Ecocardiografía Transesofágica , Resultado Fatal , Femenino , Neoplasias Cardíacas/tratamiento farmacológico , Neoplasias Cardíacas/genética , Humanos , Linfoma Anaplásico de Células Grandes/genética , Linfoma Anaplásico de Células Grandes/terapia , Miocardio , Proteínas de Fusión Oncogénica/biosíntesis , Proteínas de Fusión Oncogénica/genética , Proteínas de Fusión Oncogénica/inmunología , Proteínas Tirosina Quinasas/biosíntesis , Proteínas Tirosina Quinasas/genética , Proteínas Tirosina Quinasas/inmunología , Proteínas Tirosina Quinasas Receptoras , Neoplasias Cutáneas/genética , Neoplasias Cutáneas/cirugíaRESUMEN
Permanent alopecia can occur following treatment for pediatric malignant disease, especially cranial irradiation, resulting in identity and self-image problems. This late effect is usually addressed through external cosmesis and psychological adjustment. Surgical options are less commonly utilized. The experience of reconstructive procedures in patients at RLC NHS Trust, Alder Hey with alopecia is presented. Four patients had scalp tissue expansion and one had hair transplantation. The reconstructive options available are discussed as well as the potential opportunities and difficulties in this population. Post-radiotherapy alopecia can be successfully addressed by reconstructive surgery, and should be considered more often in this population.