ABSTRACT
El linfoma primario de hueso es una enfermedad infrecuente, que tiene una presentación y evolución diferente a los linfomas de otras localizaciones. Se presenta un caso de linfoma primario de hueso de localización craneana y esternal de rápido crecimiento. En su evolución, realizada la exéresis de la lesión primaria de calota, presentó aparición de nuevas lesiones de rápido crecimiento a nivel craneano y fémur y progresión de lesión preesternal que, con anatomía patológica de linfoma no Hodgkin difuso de células grandes B, inició R-CHOPP (ciclofosfamida, doxorrubicina, vincristina, prednisona y rituximab) con rápida disminución de todas las lesiones sin evidencia de progresión al cabo de los seis ciclos.
Primary bone lymphoma is a rare disease, which usually has a different presentation and evolution than lymphomas of other locations. We are presenting a case of primary bone lymphoma of rapid growth, in cranial and sternal locations. In its evolution, once the excision of the primary lesion of the skull was performed, the patient presented new lesions of rapid growth at the skull and femur level, and progression of pre-sternal lesion. With large B-cell diffuse non-Hodgkin lymphoma pathology, the patient initiated R-CHOPP (cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab) with rapid reduction of all lesions without evidence of progression after the six cycles.
Subject(s)
Female , Humans , Middle Aged , Bone Neoplasms/pathology , Lymphoma, Large B-Cell, Diffuse/pathology , Neoplasms, Multiple Primary/pathology , Skull Neoplasms/pathology , Sternum/pathology , Antibodies, Monoclonal, Murine-Derived/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bone Neoplasms/drug therapy , Cyclophosphamide/therapeutic use , Doxorubicin/therapeutic use , Femoral Neoplasms/drug therapy , Femoral Neoplasms/pathology , Lymphoma, Large B-Cell, Diffuse/drug therapy , Neoplasms, Multiple Primary/drug therapy , Prednisone/therapeutic use , Rare Diseases/drug therapy , Rare Diseases/pathology , Skull Neoplasms/drug therapy , Vincristine/therapeutic useABSTRACT
Osteosarcoma is a fatal disease. Neoadjuvant chemotherapy combined with irradiation treatment provide a better survival. In the Faculty of Medicine, Ramathibodi Hospital, the overall 9 year survival probability was 55 per cent among 130 cases of more than Enneking stage II osteosarcoma. Between 15 cases of bony metastases, there were 2 cases which were classified as multifoci osteosarcoma or osteosarcomatosis. These two cases developed second bone disease, 32 and 38 months after initial diagnosis and survived for 84 and 88 months with one patient also developing pulmonary metastasis. Both of them are still alive and in very good health.