Rapid Evolving Unilateral Indurated Oozing Facial Plaques in a Patient with Head-and-Neck Cancer: Peripheral T-Cell Lymphoma Not Otherwise Specified (NOS)
Identifieur interne : 000246 ( Main/Exploration ); précédent : 000245; suivant : 000247Rapid Evolving Unilateral Indurated Oozing Facial Plaques in a Patient with Head-and-Neck Cancer: Peripheral T-Cell Lymphoma Not Otherwise Specified (NOS)
Auteurs : Uwe Wollina ; Gesina Hansel ; Dana Langner ; André Koch ; Jacqueline Schönlebe ; Georgi TchernevSource :
- Open Access Macedonian Journal of Medical Sciences [ 1857-9655 ] ; 2017.
Abstract
The sudden development of facial plaques and nodules may be an alarming clinical sign for underlying malignancies. Nevertheless, a broad range of inflammatory and infectious diseases must be considered as well in the differential diagnosis.
We report on a 53-year-old male patient with a left-sided cheek infiltration with oozing but no lymphadenopathy. He had a medical history of head-and-neck cancer. The primary differential diagnosis was herpes zoster with secondary impetiginization or pyoderma facial. About eight weeks later, the patient presented with progressive formation of nodules and plaques on the face and isotretinoin was stopped. Skin biopsy suggested mycosis fungoid and an oral treatment with bexarotene was started. After limited response for another eight weeks, he returned later with massive facial swelling, nodules and impetiginization. Another skin biopsy was performed to exclude diagnostic error or investigate possible disease progression. Microscopic evaluation and multiplex-polymerase chain reaction confirmed the diagnosis of peripheral T-cell lymphoma, not otherwise specified (PTL-NOS), stage Ia (T1 N0 M0). Imaging techniques excluded metastatic spread. By interdisciplinary tumour board, R-CHOP (rituximab, cyclophosphamide, hydroxyl-doxorubicin, vincristine, and prednisolone) was recommended and initiated by hemato-oncologists.
PLT-NOS confirmed in the present patient has a poor prognosis with a 5-year survival rate of less than 20%.
Url:
DOI: 10.3889/oamjms.2017.085
PubMed: 28785337
PubMed Central: 5535662
Affiliations:
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sort="Langner, Dana" uniqKey="Langner D" first="Dana" last="Langner">Dana Langner</name><affiliation><nlm:aff id="aff1"><italic>Department of Dermatology and Allergology, “Georg Schmorl”, Academic Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067 Dresden, Germany</italic></nlm:aff></affiliation></author><author><name sortKey="Koch, Andre" sort="Koch, Andre" uniqKey="Koch A" first="André" last="Koch">André Koch</name><affiliation><nlm:aff id="aff1"><italic>Department of Dermatology and Allergology, “Georg Schmorl”, Academic Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067 Dresden, Germany</italic></nlm:aff></affiliation></author><author><name sortKey="Schonlebe, Jacqueline" sort="Schonlebe, Jacqueline" uniqKey="Schonlebe J" first="Jacqueline" last="Schönlebe">Jacqueline Schönlebe</name><affiliation><nlm:aff id="aff2"><italic>Institute of Pathology, “Georg Schmorl”, Academic Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067 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Academic Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067 Dresden, Germany</italic></nlm:aff></affiliation></author><author><name sortKey="Hansel, Gesina" sort="Hansel, Gesina" uniqKey="Hansel G" first="Gesina" last="Hansel">Gesina Hansel</name><affiliation><nlm:aff id="aff1"><italic>Department of Dermatology and Allergology, “Georg Schmorl”, Academic Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067 Dresden, Germany</italic></nlm:aff></affiliation></author><author><name sortKey="Langner, Dana" sort="Langner, Dana" uniqKey="Langner D" first="Dana" last="Langner">Dana Langner</name><affiliation><nlm:aff id="aff1"><italic>Department of Dermatology and Allergology, “Georg Schmorl”, Academic Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067 Dresden, Germany</italic></nlm:aff></affiliation></author><author><name sortKey="Koch, Andre" sort="Koch, Andre" uniqKey="Koch A" first="André" last="Koch">André Koch</name><affiliation><nlm:aff id="aff1"><italic>Department of Dermatology and Allergology, “Georg Schmorl”, Academic Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067 Dresden, Germany</italic></nlm:aff></affiliation></author><author><name sortKey="Schonlebe, Jacqueline" sort="Schonlebe, Jacqueline" uniqKey="Schonlebe J" first="Jacqueline" last="Schönlebe">Jacqueline Schönlebe</name><affiliation><nlm:aff id="aff2"><italic>Institute of Pathology, “Georg Schmorl”, Academic Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067 Dresden, Germany</italic></nlm:aff></affiliation></author><author><name sortKey="Tchernev, Georgi" sort="Tchernev, Georgi" uniqKey="Tchernev G" first="Georgi" last="Tchernev">Georgi Tchernev</name><affiliation><nlm:aff id="aff3"><italic>Department of Dermatology, Venereology and Dermatologic Surgery, Medical Institute of Ministry of Interior, and Onkoderma Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria</italic></nlm:aff></affiliation></author></analytic><series><title level="j">Open Access Macedonian Journal of Medical Sciences</title><idno type="eISSN">1857-9655</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="st1"><title>BACKGROUND</title><p>The sudden development of facial plaques and nodules may be an alarming clinical sign for underlying malignancies. Nevertheless, a broad range of inflammatory and infectious diseases must be considered as well in the differential diagnosis.</p></sec><sec id="st2"><title>CASE REPORT</title><p>We report on a 53-year-old male patient with a left-sided cheek infiltration with oozing but no lymphadenopathy. He had a medical history of head-and-neck cancer. The primary differential diagnosis was herpes zoster with secondary impetiginization or pyoderma facial. About eight weeks later, the patient presented with progressive formation of nodules and plaques on the face and isotretinoin was stopped. Skin biopsy suggested mycosis fungoid and an oral treatment with bexarotene was started. After limited response for another eight weeks, he returned later with massive facial swelling, nodules and impetiginization. Another skin biopsy was performed to exclude diagnostic error or investigate possible disease progression. Microscopic evaluation and multiplex-polymerase chain reaction confirmed the diagnosis of peripheral T-cell lymphoma, not otherwise specified (PTL-NOS), stage Ia (T1 N0 M0). Imaging techniques excluded metastatic spread. By interdisciplinary tumour board, R-CHOP (rituximab, cyclophosphamide, hydroxyl-doxorubicin, vincristine, and prednisolone) was recommended and initiated by hemato-oncologists.</p></sec><sec id="st3"><title>CONCLUSIONS</title><p>PLT-NOS confirmed in the present patient has a poor prognosis with a 5-year survival rate of less than 20%.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Carter, A" uniqKey="Carter A">A Carter</name></author><author><name sortKey="Viswanathan, K" uniqKey="Viswanathan K">K Viswanathan</name></author><author><name sortKey="Shulman, K" uniqKey="Shulman K">K Shulman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Khan, U" uniqKey="Khan U">U Khan</name></author><author><name sortKey="Rizvi, H" uniqKey="Rizvi H">H Rizvi</name></author><author><name sortKey="Ali, F" uniqKey="Ali F">F Ali</name></author><author><name sortKey="Lebovic, D" uniqKey="Lebovic D">D 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Gallamini</name></author><author><name sortKey="Stelitano, C" uniqKey="Stelitano C">C Stelitano</name></author><author><name sortKey="Calvi, R" uniqKey="Calvi R">R Calvi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rodriguez Abreu, D" uniqKey="Rodriguez Abreu D">D Rodriguez-Abreu</name></author><author><name sortKey="Filho, Vb" uniqKey="Filho V">VB Filho</name></author><author><name sortKey="Zucca, E" uniqKey="Zucca E">E Zucca</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list></list><tree><noCountry><name sortKey="Hansel, Gesina" sort="Hansel, Gesina" uniqKey="Hansel G" first="Gesina" last="Hansel">Gesina Hansel</name><name sortKey="Koch, Andre" sort="Koch, Andre" uniqKey="Koch A" first="André" last="Koch">André Koch</name><name sortKey="Langner, Dana" sort="Langner, Dana" uniqKey="Langner D" first="Dana" last="Langner">Dana Langner</name><name sortKey="Schonlebe, Jacqueline" sort="Schonlebe, Jacqueline" uniqKey="Schonlebe J" first="Jacqueline" last="Schönlebe">Jacqueline Schönlebe</name><name sortKey="Tchernev, Georgi" sort="Tchernev, Georgi" uniqKey="Tchernev G" first="Georgi" last="Tchernev">Georgi Tchernev</name><name sortKey="Wollina, Uwe" sort="Wollina, Uwe" uniqKey="Wollina U" first="Uwe" last="Wollina">Uwe Wollina</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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