Eyelid Localization in Mantle Cell Lymphoma: Long-Lasting Complete Remission after Surface Brachytherapy

Franco, Pierfrancesco; Filippi, Andrea Riccardo; Ricca, Irene; Raucci, Carlo; Ricardi, Umberto

doi:10.1177/030089160909500321

Cited by 6 publications

(5 citation statements)

References 27 publications

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“…While radiation therapy has been used for the management of orbit and adnexal involvement [ 9 ], intravitreal injections of chemotherapeutic agents such as methotrexate (MTX) and rituximab (anti-CD20) have been used for patients with vitreoretinal NHL [ 10 , 11 ]. The treatment for iris metastasis has not been well described in literature.…”

Section: Resultsmentioning

confidence: 99%

Combined systemic and ocular chemotherapy for anterior segment metastasis of systemic mantle cell lymphoma

Agarwal

Sadiq

Rhoades

et al. 2015

J Ophthal Inflamm Infect

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BackgroundMantle cell lymphoma (MCL) is an aggressive subtype of non-Hodgkin’s lymphoma that rarely metastasizes to the iris and the anterior segment. Blastic/pleomorphic morphology is thought to have an adverse effect on prognosis in MCL. MCL is resistant to conventional chemotherapeutic regimens with a tendency for multiple relapses. Management of anterior segment metastasis of systemic MCL has not been described in literature.FindingsA 58-year-old male presented with an aggressive, relapsing, metastatic, systemic blastic variant of MCL with ocular involvement. At the time of initial presentation, large tumor cells were visible in the anterior chamber (AC) along with hypopyon and fibrin. The AC cells stained positively for CD20. The iris was thickened and coated with lymphoma cells. Iris neovascularization was present. Given extensive systemic and ocular involvement, the patient was given combination chemotherapy with systemic ibrutinib and intravitreal injections of methotrexate and rituximab. The disease response was monitored using multimodal imaging, including anterior segment optical coherence tomography and ultrasound biomicroscopy. Following combination of systemic and intraocular chemotherapy, there was a marked decrease in the ocular tumor load and the systemic disease.ConclusionsCombination therapy with intravitreal injections of chemotherapeutic agents targeting monoclonal B-cell population and novel systemic agents may help to achieve remission in anterior segment metastasis of aggressive subtypes of NHL such as blastic variant of MCL. Multimodal imaging may assist in the management of these cases.

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Section: Resultsmentioning

confidence: 99%

Combined systemic and ocular chemotherapy for anterior segment metastasis of systemic mantle cell lymphoma

Agarwal

Sadiq

Rhoades

et al. 2015

J Ophthal Inflamm Infect

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“…198 There is a case report of primary cutaneous CD30-positive anaplastic large-cell lymphoma of the medial canthus and orbit that responded to local radiation therapy. 200 Mantle cell lymphoma involving the orbit, lacrimal gland, or eyelids is a sign of advanced-stage disease. 200 Mantle cell lymphoma involving the orbit, lacrimal gland, or eyelids is a sign of advanced-stage disease.…”

Section: Cutaneous Melanomamentioning

confidence: 99%

“…199 Mantle cell lymphoma represents 2-7% of non-Hodgkin's lymphomas in the periocular region and may be responsive to brachytherapy. 200 Mantle cell lymphoma involving the orbit, lacrimal gland, or eyelids is a sign of advanced-stage disease. 201 Other rare reported periocular malignancies include primary ophthalmic rhabdomyosarcoma, mucinous carcinoma, ductopapillary apocrine carcinoma, mucinous eccrine adenocarcinoma, Kaposi sarcoma, signet ring carcinoma, and malignant syringoma.…”

Section: Cutaneous Melanomamentioning

confidence: 99%

Periocular Cutaneous Malignancies: A Review of the Literature

Slutsky

Jones

2012

Dermatologic Surgery

105

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Timely diagnosis and management of periocular malignancies is essential because of their proximity to and potential to invade vital structures such as the orbit, sinuses, and brain. Surgical excision remains the standard of care for the majority of periorbital malignancies, but given the sensitive anatomic location, tissue-sparing techniques with margin control such as Mohs micrographic surgery are the preferred method for most nonmelanoma skin cancers. Depending on tumor type, other treatment modalities may include radiation, chemotherapy, cryosurgery, topical medications, and photodynamic therapy.

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“…Brachytherapy can be delivered by superficial (with dedicated commercial or customized applicators) [23,24,25,26,27,28] or interstitial application (with hypodermic needles or catheters) [29,30,31,32].…”

Section: Purposementioning

confidence: 99%

Mould-based surface high-dose-rate brachytherapy for eyelid carcinoma

Vavassori

Riva

Durante

et al. 2019

jcb

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Purpose: To evaluate toxicity and clinical outcomes in patients with eyelid tumour treated with contact high-doserate brachytherapy (HDR-BT). Material and methods: Between April 2010 and August 2017, 10 consecutive patients with tumour of the eyelid underwent contact HDR-BT and custom-made surface mould. Every applicator was manually built using conventional thermoplastic material and standard plastic catheters. The median dose prescribed was 42 Gy (range, 30-48) with a median dose per fraction of 3.5 Gy (range, 2-4.5). The dose was delivered in a median of 12 fractions (range, 10-17) over a median of 16 days. In all cases, an ocular shield was placed to reduce the dose to the eye. Acute and late toxicity was evaluated according to RTOG toxicity criteria. Results: We analyzed data of 9 of 10 patients (one patient was excluded because he did not give consent for investigation). The median age was 68 years (range, 31-88). According to the TNM-UICC staging system, 4, 1 and 4 patients were stage IA, IB and IC, respectively. Basal cell and sebaceous gland carcinomas were reported in 5 and 2 patients, respectively; other histological types were non-Hodgkin lymphoma and plasmacytoma. After a median follow-up of 51 months (range, 16-90), there was no evidence of local or distant recurrence. The treatment was very well tolerated. Most commonly acute reactions consisted of low grade (G1-G2) conjunctivitis and skin erythema. Only one patient required a temporary interruption of the treatment due to acute G2 conjunctivitis and G3 lid erythema. Only one G2 late toxicity was reported (corneal ulceration), without resulting in functional impairment or blindness. Conclusions: Our results suggest that contact HDR-BT with a customized applicator is safe, effective and offers very good local control and can be considered for the treatment of eyelid tumours.

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Eyelid Localization in Mantle Cell Lymphoma: Long-Lasting Complete Remission after Surface Brachytherapy

Cited by 6 publications

References 27 publications

Combined systemic and ocular chemotherapy for anterior segment metastasis of systemic mantle cell lymphoma

Combined systemic and ocular chemotherapy for anterior segment metastasis of systemic mantle cell lymphoma

Periocular Cutaneous Malignancies: A Review of the Literature

Mould-based surface high-dose-rate brachytherapy for eyelid carcinoma

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