Radiotherapy as Salvage Treatment in Intraocular Lymphoma: A Case Report
Autor: | Ilda Costa, A. Mota, Marta Guedes, Raul Colaço, Mariana Portela |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
0301 basic medicine
medicine.medical_specialty genetic structures medicine.medical_treatment Optic chiasm Case Report lcsh:RC254-282 03 medical and health sciences 0302 clinical medicine Medicine External beam radiotherapy Bitemporal hemianopsia radiotherapy Left optic tract primary central nervous system lymphoma business.industry Primary central nervous system lymphoma medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens eye diseases Radiation therapy 030104 developmental biology medicine.anatomical_structure Oncology intraocular lymphoma 030220 oncology & carcinogenesis Rituximab Radiology Intraocular lymphoma business medicine.drug |
Zdroj: | Case Reports in Oncology, Vol 14, Iss 1, Pp 184-189 (2021) Case Reports in Oncology |
ISSN: | 1662-6575 |
Popis: | A 67-year-old previously healthy woman presented with progressive visual impairment including bitemporal hemianopsia. A brain magnetic resonance imaging revealed a contrast-enhancing mass in the optic chiasm, spreading along the left optic tract. The patient underwent a transcranial biopsy of the left optical tract that yielded a diagnosis of diffuse large B-cell lymphoma. CT scans of the chest, abdomen, and pelvis, PET-CT, and bone marrow biopsy revealed no evidence of systemic lymphoma. Thus, the final diagnosis was of primary central nervous system lymphoma of the optic chiasm. Systemic treatment was initiated with full response. Six months after the end of the treatment, recurrence at cerebellum parenchyma and left tentorium was recorded. A new systemic treatment achieved full response. A second recurrence was noted in an optical coherence tomography of the right eye, 2 years after the initial diagnosis. The patient was treated with intravitreal methotrexate with initial success, but eventual failure after 10 months. Intravitreal rituximab was used with no effect. The patient was then referred to radiotherapy and underwent external beam radiotherapy with VMAT. There were no acute toxicities to report. After the radiotherapy treatment, at 1-year follow-up, the patient has no evidence of disease. Long-term toxicities were recorded and are considered manageable. The present case emphasizes the role of ocular irradiation as an option in the management of intraocular lymphoma patients, including in the salvage setting, with an acceptable ocular toxicity profile. |
Databáze: | OpenAIRE |
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