Primary Extranodal Hodgkin's Lymphoma presenting with a Single Pelvic Mass

Abstract

ABSTRACT Introduction Although lymphomas can arise from a wide variety of tissues, primary extranodal presentation is predominantly a feature of non-Hodgkin's lymphomas. Primary pelvic extranodal Hodgkin's lymphoma is a rare malignancy. We presented a case of primer retroperitoneal Hodgkin's lymphoma initially presumed gynecologic malignancy. We discussed its rarity, staging and management. Case Report A 75-year-old woman was referred to our hospital with persisting pelvic mass. Pelvic examination revealed an ill-defined immobile mass with hard in consistency. The mass 100 × 75 mm in diameter, invading right parametrium, perivesical space and bladder wall was detected in CT and there were no signs of metastases or enlarged lymph nodes. Diagnostic laparoscopy was suggested but the patient refused the surgery due to her advanced age. One year later, she presented with the symptoms of fever, sweats and fatigue. Hodgkin's lymphoma was diagnosed via laparoscopic biopsy of the mass located at retroperitoneal space anteriorly to the uterus. CT examination revealed multiple swollen lymph nodes and a pulmonary nodule; thus, stage 4 disease was established. International prognostic score was 2, indicating 67% progression free survival; however, patient died due to respiratory failure after the first course of ABVD chemotherapy. Conclusion Although gynecologists rarely experience primary extranodal lymphomas particularly Hodgkin's disease, lymphoid malignancies should be kept in mind in differential diagnosis of pelvic masses. This disease can rarely arise adjacent to gynecologic organs in retroperitoneal space, and this presentation can be misinterpreted as a gynecological malignancy. How to cite this article Kiran G, Canaz E, Sayar H, Serin S, Balakan O. Primary Extranodal Hodgkin's Lymphoma presenting with a Single Pelvic Mass. J South Asian Feder Obst Gynae 2014;6(3):183-186.