The incidences of other primary cancers in patients with mycosis fungoides and Sézary syndrome

Abstract

Introduction: Cutaneous T-cell lymphomas (CTCLs) are a diverse group of non-Hodgkin's lymphomas with malignant T lymphocytes infiltrating the skin. Mycosis fungoides (MF) and Sézary syndrome (SS) belong to the group of CTCLs, among others. In previous studies it was suggested that primary cancers more often occur in patients with cutaneous lymphoma. Aim: To analyse the incidence of other malignancies in CTCL patients. Material and methods: The evaluation of the coexistence of primary malignant neoplasms in CTCL patients was conducted by analysis of the patients' database, with diagnosis of mycosis fungoides and Sézary syndrome, treated in the Dermatological Department of the Medical University of Gdansk between 2010 and 2018. Results: Among CTCL patients, 177 were diagnosed with MF/SS (stage MFIA 37.61%, MFIB 30.77%, MFIIA 0.85%, MFIIB 11.11%, MFIII 8.55% MFIV 4.27%; SS 6.84%). The group was characterized by a male-to-female ratio of 1.21 : 1. 16.94% of MF/SS patients had one co-existing cancer, while 1.13% of patients had 2 co-existing cancers; the most common were basal cell carcinoma, lymphomatoid papulosis, lung cancer, and B-cell lymphoma. The obtained data highlight that MF/SS is associated with increased risk of cancer. Conclusions: Our study suggests that special attention should be paid to careful examination of CTCL patientswhat force to perform solid clinical examination, the X-ray chest examination, abdomen USG, mammography, and others, even in early stages of MF/SS. Clinicians should be aware of the coexistence of other neoplasms such as lung, skin, and breast cancer.

Evaluation of secondary malignancies in a large series of mycosis fungoides

“…First of all, some studies included patients only with MF 7 , 11 , 12 , 14 , 17 , 18 , 19 , 21 , 23 or Sézary syndrome 5 while others included MF and Sézary syndrome together. 8 , 10 , 15 , 16 , 20 , 22 Moreover, a few studies referred to their patient group as Cutaneous T-Cell Lymphoma (CTCL) 3 , 4 , 6 , 9 , 13 ( Table 2 ). In addition, some ancient studies primarily focused on cutaneous malignancies due to the possible association with phototherapy applied in the management of MF with limited attention to other SMs.…”

“… 1 , 2 Although there are studies suggesting an increased risk of Secondary Malignancies (SMs) in MF patients; particularly systemic lymphomas, factors predisposing to SMs are not described and routine screening for them is still not recommended. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 The previous studies were limited primarily to either the United States of America (USA) 3 , 8 , 9 , 10 , 13 , 15 , 16 , 17 , 18 , 19 or Europe (Great Britain and Finland, Denmark, Germany, Poland, Italy), 5 , 6 , 7 , 12 , 21 , 22 , 23 and scarcely to other geographical regions. 11 , 14 , 20 It is important to investigate the epidemiology of MF-associated malignancies in diverse populations to properly define the pathogenic role of genetic and environmental factors.…”

Primary cutaneous lymphomas. Diagnostic and therapeutic guidelines of the Polish Dermatological Society (PTD) and Polish Lymphoma Research Group (PLRG)

“…Dermatology Review/Przegląd Dermatologiczny 2023/6 tic imaging, as it is essential for precisely establishing the N and M criteria. It is important to note that MF and lymphomatoid papulosis (LyP) are associated with a higher risk of other concomitant malignancies, and without imaging findings their diagnosis may be delayed [2]. In patients at disease stages other than IA and IB, computed tomography (CT) imaging of the head, neck, thorax, abdomen, and pelvis, or positron emission tomography (PET) are recommended to accurately determine TNM staging.…”