Background: Syringolymphoid hyperplasia with alopecia is considered to be a rare variant of cutaneous T-cell lymphoma. Current therapy for cutaneous T-cell lymphoma limited to the skin favors topical treatment, chemo-, and photochemotherapy. Case Report: We report on a 52-year-old patient presenting with disseminated, reddish-brown scaly papules on both soles and erythematous papules with alopecia on his thighs. First skin lesions arose 5 years ago and subsequently a continuous progression was noted. Finally, the patient was severely limited due to pressure-induced pain on the soles. Topical glucocorticosteroids, local PUVA bath therapy, and systemic interferon-α administration failed to improve skin lesions. Thus, a local radiotherapy with ⁶⁰Co γ-rays was administered. A total dose of 30 Gy was delivered in 2-Gy fractions over a 3-week period. Clinically, there was a complete regression of irradiated skin lesions. Conclusion:Though there is limited experience regarding the therapy of syringolymphoid hyperplasia with alopecia, radiotherapy has to be considered in recalcitrant cases.

SUMMARY Cancer of unknown primary (CUP) syndrome presenting as metastatic lymph nodes of unknown primaries in the head and neck is a difficult clinical problem. The optimal treatment policy is not yet defined. A retrospective analysis of the clinical outcome and side effects of 41 patients with CUP syndrome treated with different irradiation techniques is given in this report. Tweny-eight patients received "involved field" irradiation confined to the involved neck and all the other patients were treated with "extended fields" including the contralateral neck and oro-and hypopharynx. The relative risk of recurrence was 30% and 56% after 1 and 3 years for patients irradiated with "involved fields" and 56% for both periods for patients treated with "extended fields." During follow-up the primary tumor was detected in 11 patients. In conclusion, after thorough diagnostic workup and surgery, limited radiotherapy to the involved neck is justified. Rudiut

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