Aggressive Lymphoma “Sarcoma Mimicker” Originating in the Gluteus and Adductor Muscles: A Case Report and Literature Review

Author:

Elkourashy Sarah A.1,Nashwan Abdulqadir J.2,Alam Syed I.3,Ammar Adham A.4,Sayed Ahmed M. El5,Omri Halima El6,Yassin Mohamed A.6

Affiliation:

1. Clinical Fellow, Department of Hematology and BMT, National Center for Cancer Care and Research (NCCCR) – Hamad Medical Corporation (HMC), Doha, Qatar.

2. Nurse Educator, Nursing Department, National Center for Cancer Care and Research (NCCCR) – Hamad Medical Corporation (HMC), Doha, Qatar.

3. Radiology Specialist, Hamad Medical Corporation (HMC), Doha, Qatar.

4. Laboratory Consultant, Hamad Medical Corporation (HMC), Doha, Qatar.

5. Orthopedic Consultant, Department of Surgery, Hamad Medical Corporation (HMC), Doha, Qatar.

6. Hematology Consultant, Department of Hematology and BMT, National Center for Cancer Care and Research (NCCCR)-Hamad Medical Corporation (HMC), Doha, Qatar.

Abstract

Extranodal lymphoma (ENL) occurs in approximately 30%–40% of all patients with non-Hodgkin lymphoma and has been described in almost all organs and tissues. However, diffuse large B-cell lymphoma is the most common histological subtype of non-Hodgkin lymphoma, primarily arising in the retroperitoneal region. In this article, we report a rare case of an adult male diagnosed with primary diffuse large B-cell lymphoma of the gluteal and adductor muscles with aggressive bone involvement. All appropriate radiological and histopathological studies were done for diagnosis and staging. After discussion with the lymphoma multidisciplinary team, it was agreed to start on R-CHOP protocol (rituximab, cyclophosphamide, doxorubicin (Adriamycin), vincristine (Oncovin®), and prednisone) as the standard of care, which was later changed to R-CODOX-M/R-IVAC protocol (rituximab, cyclophosphamide, vincristine (Oncovin®), doxorubicin, and high-dose methotrexate alternating with rituximab, ifosfamide, etoposide, and high-dose cytarabine) due to inadequate response. Due to the refractory aggressive nature of the disease, subsequent decision of the multidisciplinary team was salvage chemotherapy and autologous stem cell transplant. The aim of this case report was to describe and evaluate the clinical presentation and important radiological features of extranodal lymphoma affecting the musculoskeletal system.

Publisher

SAGE Publications

Subject

General Medicine

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