Non-Hodgkin's ovarian lymphoma during adolescence: report of two cases

Ovarian Non-Hodgkin Lymphoma Revealed by Bone Metastasis: A Rare Pediatric Case

Ovary involvement of non-Hodgkin lymphoma (NHL) is rare. We report a rare case of ovarian NHL during adolescence revealed by bone metastasis. The diagnosis of malignant lymphoma was established after adnexectomy and histological study of the excised tissue. The tumor was classified as a diffuse large B-cell lymphoma. The patient has been treated according to the LMB French protocol with good outcome after two years. Although NHL is a rare ovarian neoplasm, it is essential to establish an accurate diagnosis as early as possible for therapeutic purposes.

Characteristics and outcome of pediatric non-Hodgkin lymphoma patients with ovarian infiltration at presentation

BACKGROUND

Ovarian infiltration in pediatric non-Hodgkin lymphoma (NHL) at presentation is rare and information on outcome is scarce and mainly based on case reports and small series.

PROCEDURE

Evaluation of clinical characteristics and outcome of ovarian infiltrated pediatric NHL cases of a single center, and an extensive review of the all cases reported so far in literature.

RESULTS

At presentation, 6/60 female NHL cases of our center had ovarian infiltration, and combining these cases with earlier case reports, a total of 42 cases were identified. Median age at presentation was 10.9 years (range 0-18), and all but one had a B-cell immunophenotype, with 32/42 cases being classified as Burkitt. Bilateral involvement was reported in 26/41 cases, of which 22 were bilaterally ovariectomized as first treatment. All cases were treated with chemotherapy. Relapses were reported in 9/36 and death in 16/36. After follow-up in our center (median 13.4 years), in 2 cases anti-Müllerian hormone (AMH) values were available (2.1 and 0.9 µg/L), in non-ovarian cases median 2.2 µg/L.

CONCLUSIONS

We conclude that in case of ovarian tumors with negative markers, NHL should be considered in order to avoid unnecessary surgery.

Primary Burkitt's Lymphoma of the Ovary in Early Weeks of Pregnancy - A Case Report

Primary ovarian Burkitt's lymphoma is a rare tumour predominantly affecting children and young adults. We report here on a 17-year-old pregnant woman with a Burkitt's lymphoma of the left ovary. After tumour removal and induced abortion, the patient underwent polychemotherapy. Full remission was achieved 7 months after the initial diagnosis.

Primary ovarian large B-cell lymphoma in patient with juvenile rheumatoid arthritis treated with low dose Methotrexate

BACKGROUND

Primary ovarian lymphoma is an extremely rare disease and limited count reports about it have been reported in the literature. Traditionally, patients with rheumatoid arthritis (RA) have increased risk of nodal and extranodal lymphoid malignancies such as non-Hodgkin's lymphoma (NHL). Recently, some studies have also reported association between patients with juvenile rheumatoid arthritis (JRA) treated with Methotrexate (MTX) and malignant lymphoma developing.

CASE

We report a 17-year old JRA patient with primary ovarian diffuse large B-cell non-Hodgkin's lymphoma (NHL). The patient had seronegative (rheumatoid factor negative) poliarticular form of JRA and was receiving low dose weekly Methotrexate (MTX) during the past 2 years. Initial presentation was adnexial mass and chronic pelvic pain. The patient was treated with surgery and combined cytotoxic chemotherapy.

CONCLUSION

In conclusion, because of increased lymphoid malignancy risk, ovarian masses in JRA patients should be carefully evaluated.