The effect of the surgical treatment in the complex management on life expectancy of thymic Hodgkin's lymphoma

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The result of treatment of primary Hodgkin's lymphoma lesion of the thymus gland of a 26-year-old patient is presented. At the preoperative stage of examination, “tumor maligna” cells were obtained during puncture of mediastinal formation. The diagnosis is malignant tumor of the mediastinum. Considering this, a surgical treatment was performed-radical removal of the mediastinal tumor. After the study of the postoperative drug, a clinical diagnosis was made: lymphogranulomatosis, a massive (bulky) tumor lesion of the mediastinum, stage IIХ, after surgical treatment. First course of ABVD chemotherapy was performed 28 days after the operation. When performing the second course of chemotherapy according to the same scheme, the patient developed complications in the form of moderate leukocytopenia (leukocytes, 0.9×109/l) and stomatitis. Special treatment was discontinued, and the patient was observed by an oncologist in the polyclinic of an oncological dispensary.

At the next examination, which was performed 11 months later, a relapse of the disease was identified. Considering the preservation of persistent leukopenia (leukocytes, 3.0×109/l), it was decided to conduct six courses of ABVD polychemotherapy with prednisone, against the background of G-CSF. At this stage of oncology, the main method of treating Hodgkin's lymphoma is chemo-hormone therapy in combination with radiation therapy. The performed non-standard complex treatment is radical surgical removal of a mediastinal tumor followed by polychemotherapy. It allowed 4 years after the completion of treatment to know motherhood, which did not affect the patient's health. As indicated by the long relapse, free period of the disease is 16 years, and life expectancy is 18 years.

作者简介

Sergey Fokeev

Altai State Medical University

编辑信件的主要联系方式.
Email: fokeev.sergey@yandex.ru
ORCID iD: 0000-0002-1157-6692
SPIN 代码: 9609-0896

Dr. Sci. (Med.), Associate Professor
俄罗斯联邦, Barnaul

Alexander Lazarev

Altai State Medical University

Email: lazarev@akzs.ru
ORCID iD: 0000-0003-1080-5294
SPIN 代码: 1161-8387

Dr. Sci. (Med.), Professor
俄罗斯联邦, Barnaul

Stanislav Kapitulin

Altai State Medical University

Email: stass0331429@mail.ru
ORCID iD: 0000-0001-8131-3161
SPIN 代码: 1217-0508

Cand. Sci. (Med.), Associate Professor
 
俄罗斯联邦, Barnaul

Elena Kazantseva

Autonomous Noncommercial Organization “NIITO Clinic” (ANO “NIITO Clinic”)

Email: ktyf1984@yandex.ru
ORCID iD: 0000-0003-3575-047X
SPIN 代码: 5074-1757

Cand. Sci. (Med.)
 
俄罗斯联邦, Novosibirsk

Elina Kapitulina

City Hospital No. 5

Email: elinalevina4@gmail.com
ORCID iD: 0000-0002-3856-2012
俄罗斯联邦, Barnaul

参考

  1. Sushko AA, Prokopchik NI, Mozheyko MA, et al. Diagnostics and treatment of tumors and tumor-like formations of the mediastinum. Journal of the Grodno State Medical University. 2015;(3):51–55. (In Russ).
  2. Lazutin YuN, Kartashov SZ, Zinkovich SA, et al. Modern approaches to treatment of patients with tumours of mediastinum. Izvestia of Samara Scientific Center of the Russian Academy of Sciences . 2009;(11(5-2):468–471. (In Russ).
  3. Poteshkina NG, Troshina AA, Maslova MY, at al. Mediastinal mass in clinical practice // Medical advice. 2018;(5):104–108. (In Russ). doi: 10.21518/2079-701X-2018-5-104-108
  4. Aroor AR, Prakasha SR, Seshadri SST, Raghuraj U. A study of clinical characteristicsof mediastinal mass. J Clin Diagn Res. 2014;8(2):77–80. doi: 10.7860/JCDR/2014/7622.4013
  5. Eichenauer DA, Engert A, André M, et al. Hodgkin’s lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014;25(Suppl 3):iii70–iii75. doi: 10.1093/annonc/mdu181
  6. Mazurok LA, Kolomeitsev OA, Tumyan GS, et al. Primary mediastinal B-large cell lymphoma. Oncohematology. 2007;2(2):16–23. (In Russ).
  7. Trahtenberg AH, Pikin OV. Zlokachestvennye opuholi sredostenija. In: Chissov VI, Daryalova SL, editors. Klinicheskie rekomendacii. Onkologija 2006. Moscow; 2006. P. 246–266. (In Russ).
  8. Shavlokhov VS, Karagyulyan SR, Moiseeva TN, et al. Surgical treatment of relapsing mediastinal and pulmonary tumors in patients with Hodgkin’s disease and diffuse large B-cell lymphoma. Russian Journal of Hematology and Transfusiology. 2012;57(1):18–23 (In Russ).
  9. Shalyga IF, Grishakov VV, Martemyanova LA, et al. Hodgkin’s lymphoma with extranodular manifestations. Health and Ecology Issues. 2017;2:106–110. (In Russ).

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2. Fig. 1. X-ray of the chest in direct projection.

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3. Fig. 2. Chest X-ray, left lateral view.

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4. Fig. 3. Postoperative chest X-ray in direct projection.

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5. Fig. 4. Control radiography of the chest in direct projection 16 years after complex treatment.

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6. Fig. 5. Control radiography of the chest in the right lateral projection 16 years after complex treatment.

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版权所有 © Fokeev S.D., Lazarev A.F., Kapitulin S.Y., Kazantseva E.S., Kapitulina E.K., 2021

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