Radiation therapy for primary breast lymphoma in male gynecomastia: a rare case report and review of the literature

Abstract

Primary breast lymphoma is a rare type of non-Hodgkin lymphoma and usually affects women, although a few cases have been reported in men. Chemotherapy and radiation therapy, or a combination of both, are frequently administered for treatment of primary breast lymphoma, as local control by surgical resection is poor. No standard therapy has been established, and the optimal radiation dose and irradiation field for male patients are unknown. The present report describes a 75-year-old man with bilateral cirrhosis-induced gynecomastia who was diagnosed with primary breast lymphoma; specifically, diffuse large B-cell lymphoma. Because of his hepatic dysfunction, he was treated with radiation therapy alone. Radiation therapy was followed by eight cycles of rituximab monotherapy. Clinical response was good, with no signs of relapse. Clinicians may benefit from knowledge regarding effective treatment of primary breast lymphoma in male patients, which has been rarely reported owing to the low incidence of this condition. The outcome in the present case may help to establish effective treatment guidelines in similar cases.

Primary breast lymphoma in males: Incidence, demographics, prognostic factors, survival, and comparisons with females

“…The details of histological subclassifications of female and male patients are listed in Supplementary Tables 3 and 4 , respectively. For both genders, consistent with the previous study ( 13 ), diffuse large B-cell lymphoma was the most common type, followed by extranodal marginal zone lymphoma (mucosa-associated lymphoid tissue type) and follicular lymphoma. Thus, we hypothesize that male PBL patients may be similar to females in terms of clinical demographics.…”

Primary and Secondary Breast Lymphoma: Clinical, Pathologic, and Multimodality Imaging Review

“…Bsymptoms (systemic symptoms associated with Hodgkin and nonHodgkin lymphoma) such as fever, weight loss, and night sweats are common in SBL and are rare in PBL, potentially owing to the presence of advanced extramammary lymphoma in SBL (26)(27)(28)(29). While breast lymphoma occurs almost exclusively in women, case reports have been published docu menting the exceedingly rare diagnosis of both PBL and SBL in men (30)(31)(32).…”

Primary breast lymphoma (PBL) in men — a systematic review

“…Two studies had no English full text, so data was limited to the abstracts [8,9]. The data of 5 cases were extracted from one study which was a case report and review article [10] and the review part of this study included data of 4 cases whose original articles (case reports) were not found.…”

“…Interestingly in the present review, all eight male patients who received radiotherapy combined with other treatment modality were alive without evidence of disease after a median of 17 months [10,[24][25][26][27][28]. Four patients received higher than 30 Gy (they mostly received 50 Gy), and information about radiation dosage was not available in one patient [24].…”