Ovarian lymphomas. A clinicopathological analysis of 10 cases

Epithelioid Inflammatory Myofibroblastic Sarcoma of the Ovary With RANB2-ALK Fusion: Report of a Case

Epithelioid inflammatory myofibroblastic sarcoma (EIMS) is a recently described, clinically aggressive variant of inflammatory myofibroblastic tumor with a predilection for intraabdominal sites, tendency to arise in male patients and resistance to conventional chemotherapy and radiotherapy. We present a case of a 15-year-old girl with EIMS of the ovary with a RANBP2-ALK fusion. During 2 years of follow up, she experienced multiple recurrences. Following classification of the tumor as EIMS, the patient began treatment with an ALK inhibitor (crizotinib), which led to disease improvement within weeks of administration. To the best of our knowledge, this represents the first reported case of EIMS arising in the female genital tract.

Characteristics and outcome of pediatric non-Hodgkin lymphoma patients with ovarian infiltration at presentation

BACKGROUND

Ovarian infiltration in pediatric non-Hodgkin lymphoma (NHL) at presentation is rare and information on outcome is scarce and mainly based on case reports and small series.

PROCEDURE

Evaluation of clinical characteristics and outcome of ovarian infiltrated pediatric NHL cases of a single center, and an extensive review of the all cases reported so far in literature.

RESULTS

At presentation, 6/60 female NHL cases of our center had ovarian infiltration, and combining these cases with earlier case reports, a total of 42 cases were identified. Median age at presentation was 10.9 years (range 0-18), and all but one had a B-cell immunophenotype, with 32/42 cases being classified as Burkitt. Bilateral involvement was reported in 26/41 cases, of which 22 were bilaterally ovariectomized as first treatment. All cases were treated with chemotherapy. Relapses were reported in 9/36 and death in 16/36. After follow-up in our center (median 13.4 years), in 2 cases anti-Müllerian hormone (AMH) values were available (2.1 and 0.9 µg/L), in non-ovarian cases median 2.2 µg/L.

CONCLUSIONS

We conclude that in case of ovarian tumors with negative markers, NHL should be considered in order to avoid unnecessary surgery.

Anaplastic large cell lymphoma of the ovary in a pediatric patient

Lymphoma can rarely present as an ovarian tumor in children. We describe the unusual case of a 14-year-old adolescent with a locally disseminated ovarian anaplastic large-cell lymphoma, treated with surgery followed by chemotherapy, and who remains disease free at 2 years after diagnosis.

Primary retroperitoneal non-Hodgkin lymphoma presenting with torturous generalized pruritus in an elderly

INTRODUCTION

A case of a rare primary retroperitoneal non-Hodgkin lymphoma (NHL), which presented with torturous generalized pruritus in a 74-year-old female patient is reported

METHODS

Case report.

RESULTS

Explorative laparotomy was performed after imaging revealed a pelvic mass and an ovarian tumour was suspected. After the frozen section revealed a lymphoma, extensive surgery was omitted. The patient was successfully treated with courses of Bleo-CHOP regimen (complete response) and pruritus resolved entirely after completing the second course of chemotherapy.

CONCLUSION

This report indicates the need of thorough investigation of the peritoneal cavity for the presence of NHL in cases presenting as unexplained pruritus in the elderly. In this setting the presence of a retroperitoneal pelvic mass must raise the suspicion for the possibility of the rare retroperitoneal NHL.

[Pelvic Burkitt lymphoma mimicking an ovarian tumor]

Primary malignant lymphoma of the ovary is a rare tumor (1,5% of ovarian tumors). Clinically, it occurs as an abdominal mass with pain which can be confused with an epithelial ovary tumor. Most tumors are observed during the fourth decade. Burkitt lymphoma, is sporadic in western countries, usually with abdominal involvement. Diagnosis is guided by biological analysis and imaging. Prognosis depends on medullary and neuromeningeal involvement. Polychemotherapy is required. We report a case of a young woman who developed abdominal Burkitt Lymphoma mimicking advanced-stage bilateral ovarian cancer.

HIV-associated primary cervical non-Hodgkin's lymphoma and two other cases of primary pelvic non-Hodgkin's lymphoma

BACKGROUND

Although there have been few case series of primary pelvic non-Hodgkin's lymphoma (NHL) reported over the past two decades, no patient with acquired immunodeficiency syndrome (AIDS)-related primary pelvic NHL has been reported.

CASE

We report a human immunodeficiency virus (HIV)-infected patient with primary cervical NHL. After surgical biopsy, she received standard NHL combination chemotherapy plus standard HIV highly active antiretroviral therapy (HAART), and remains disease free 38 months since therapy. We also report two other cases of primary pelvic NHL.

CONCLUSIONS

Primary pelvic NHL is rare, with clinical presentation similar to other common gynecologic malignancies. It is treated with combination chemotherapy and pelvic radiotherapy, and generally has good prognosis. Adding HAART to other standard therapies for patients with AIDS-related pelvic lymphoma may improve the prognosis of this category of patients.