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Case report
peer-reviewed

Secondary Cutaneous Involvement in Follicular Diffuse Lymphoma Treated with Helical Tomotherapy



Abstract

Non-Hodgkin’s lymphoma is a complex heterogeneous group of disease entities that involves nodal and extranodal tissues. Cutaneous involvement can occur either as a primary or secondary in course of disease. Radiation therapy with either total body or localized treatments is often used for local control and symptom relief, depending on the target volume. We describe a 60-year-old male with a remote history of stage IA left neck follicular lymphoma treated with radiation 20 years ago and previous relapses aggressively treated by chemotherapy. Treatment to a large volume of back and posterior shoulders on a helical tomotherapy radiotherapy system is reported. The skin lesions responded completely with no toxicity. Palliative radiotherapy to a fairly large and complex volume of skin with modest dose avoiding underlying critical tissues on tomotherapy is feasible, well tolerated with an excellent durable response, without compromising future chemotherapy and stem cell transplant for systemic relapse.



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Case report
peer-reviewed

Secondary Cutaneous Involvement in Follicular Diffuse Lymphoma Treated with Helical Tomotherapy


Author Information

A. Rashid Dar

Department of Radiation Oncology, London Regional Cancer Program, Western University

Kevin Jordan

Physics, London Regional Cancer Program, Western University

Slav Yartsev Corresponding Author

Physics, London Regional Cancer Program, Western University


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.


Case report
peer-reviewed

Secondary Cutaneous Involvement in Follicular Diffuse Lymphoma Treated with Helical Tomotherapy


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Case report
peer-reviewed

Secondary Cutaneous Involvement in Follicular Diffuse Lymphoma Treated with Helical Tomotherapy

A. Rashid Dar">A. Rashid Dar, Kevin Jordan">Kevin Jordan, Slav Yartsev">Slav Yartsev

  • Author Information
    A. Rashid Dar

    Department of Radiation Oncology, London Regional Cancer Program, Western University

    Kevin Jordan

    Physics, London Regional Cancer Program, Western University

    Slav Yartsev Corresponding Author

    Physics, London Regional Cancer Program, Western University


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

    Acknowledgements


    Article Information

    Published: July 14, 2017

    DOI

    10.7759/cureus.1471

    Cite this article as:

    Dar A, Jordan K, Yartsev S (July 14, 2017) Secondary Cutaneous Involvement in Follicular Diffuse Lymphoma Treated with Helical Tomotherapy. Cureus 9(7): e1471. doi:10.7759/cureus.1471

    Publication history

    Received by Cureus: June 07, 2017
    Peer review began: June 26, 2017
    Peer review concluded: July 06, 2017
    Published: July 14, 2017

    Copyright

    © Copyright 2017
    Dar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Non-Hodgkin’s lymphoma is a complex heterogeneous group of disease entities that involves nodal and extranodal tissues. Cutaneous involvement can occur either as a primary or secondary in course of disease. Radiation therapy with either total body or localized treatments is often used for local control and symptom relief, depending on the target volume. We describe a 60-year-old male with a remote history of stage IA left neck follicular lymphoma treated with radiation 20 years ago and previous relapses aggressively treated by chemotherapy. Treatment to a large volume of back and posterior shoulders on a helical tomotherapy radiotherapy system is reported. The skin lesions responded completely with no toxicity. Palliative radiotherapy to a fairly large and complex volume of skin with modest dose avoiding underlying critical tissues on tomotherapy is feasible, well tolerated with an excellent durable response, without compromising future chemotherapy and stem cell transplant for systemic relapse.



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Create a free account to continue reading this article.

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A. Rashid Dar

Department of Radiation Oncology, London Regional Cancer Program, Western University

Kevin Jordan, Ph.D., Assistant Professor

Physics, London Regional Cancer Program, Western University

Slav Yartsev

Physics, London Regional Cancer Program, Western University

For correspondence:
slav.yartsev@lhsc.on.ca

A. Rashid Dar

Department of Radiation Oncology, London Regional Cancer Program, Western University

Kevin Jordan, Ph.D., Assistant Professor

Physics, London Regional Cancer Program, Western University

Slav Yartsev

Physics, London Regional Cancer Program, Western University

For correspondence:
slav.yartsev@lhsc.on.ca