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Case Report
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| Unique case of dual gynecological malignancies co-existing with an uncommon thyroid lymphoma | ||||||
| Kellie R Alleyne-Mike1, Khadiga EA Mohamed1, Leon van Wijk2, Francois CJ Botha3 | ||||||
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1Senior Resident, Radiation Oncology Department, Groote Schuur Hospital, Cape Town, South Africa.
2Consultant, Radiation Oncology Department, Groote Schuur Hospital, Cape Town, South Africa. 3Resident, Division of Pathology,Groote Schuur Hospital, Cape Town, South Africa. | ||||||
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| How to cite this article |
| Alleyne-Mike KR, Mohamed KEA, van Wijk L, Botha FCJ. Unique case of dual gynecological malignancies co-existing with an uncommon thyroid lymphoma. International Journal of Case Reports and Images 2013;4(12):714–718. |
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Abstract
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Introduction:
Synchronous primaries are uncommon in medical literature but pose many diagnostic and therapeutic challenges which require a multi-disciplinary approach.
Case Report: A 64-year-old female was presented with a vulva lesion and bilateral inguinal lymphadenopathy. She was also noted to have a palpable abdominal growth and an enlarged neck mass. Blood evaluation yielded elevated CA-125 and thyroid stimulating hormone levels. All other tests were unremarkable. Computed tomography of the neck showed a large thyroid mass with bilateral lobe involvement and abdominal scanning showed a large cystic lesion causing right hydronephrosis and hydroureter. She was diagnosed with a primary vulva squamous carcinoma in a background of lichen sclerosus which was managed surgically. The patient also underwent laparotomy and was found to have a borderline ovarian malignancy. A neck biopsy yielded a thyroid lymphoma which was treated with chemotherapy. Prophylactic radiation to the groin was performed after multi-disciplinary consult. There was an excellent clinical response to the treatment. Conclusion: This is the first report of concurrent vulva and ovarian pathology associated with a hematologic malignancy. Specific immunologic and genetic abnormalities have not yet been identified in literature which may link these supposedly random occurrences. However, the immune dysregulation associated with lichen sclerosus and its role in the pathogenesis of vulva squamous carcinoma is of interest in the background of a co-existing hematological malignancy, and an inherent compromised immune response. In addition, ongoing genetic research may yet elucidate a common link between these synchronous primaries. | |
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Keywords:
Synchronous primary malignancies, Thyroid lymphoma, Vulva cancer, Ovarian cancer
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Author Contributions
Kellie Alleyne-Mike – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published Khadiga Elfadil Ahmed Mohammed – Analysis and interpretation of data, Critical revision of the article, Final approval of the version to be published Adriaan Leon van Wijk – Analysis and interpretation of data, Critical revision of the article, Final approval of the version to be published Francois Cornelius Jacobus Botha – Acquisition of data, Critical revision of the article, Final approval of the version to be published. |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© Kellie Alleyne-Mike et al. 2013; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.) |
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