Successful Use of a Multidisciplinary Approach to Treat a Perforated Duodenal Malignant Lymphoma in an Elderly Patient

Treatment of duodenal malignant lymphoma is difficult due to life-threatening complications such as intestinal obstruction, perforation, and pancreatitis. Thus, multidisciplinary procedures are required alongside surgical intervention. Contrast abdominal CT images of a 75-year-old female suffering f...

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Bibliographic Details
Published in:Case reports in oncological medicine 2018-01, Vol.2018 (2018), p.1-6
Main Authors: Nakai, Osamu, Kubota, Yoshihiro, Kajiwara, Masaaki, Hinami, Junsuke, Nagano, Shinta, Matsuki, Goshi, Niimi, Yuta, Takagishi, Tomoko, Kaneko, Kiyoshi
Format: Article
Language:English
Subjects:
Abdomen
Aged patients
Cancer
Care and treatment
Case Report
Case reports
Chemotherapy
Cogeneration power plants
Colorectal cancer
Gastrointestinal diseases
Lymphoma
Monoclonal antibodies
Neutropenia
Non-Hodgkin's lymphomas
Oncology
Pancreatitis
Patients
Radiation therapy
Radiotherapy
Targeted cancer therapy
Vincristine
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Summary:Treatment of duodenal malignant lymphoma is difficult due to life-threatening complications such as intestinal obstruction, perforation, and pancreatitis. Thus, multidisciplinary procedures are required alongside surgical intervention. Contrast abdominal CT images of a 75-year-old female suffering from vomiting revealed thickening of the duodenal wall (from the second to third segment). Gastrojejunostomy and biopsy identified the tumor as diffuse large B-cell lymphoma. A diagnosis of stage II duodenal lymphoma was made. The lymphoma continued to grow, resulting in jaundice and intestinal perforation, which was first treated with two cycles of rituximab and antibiotics. Thereafter, less intensive chemotherapy (two cycles each of R-mini-CHP, CHP, and R-CHOP) was administered, which led to significant improvement upon assessment by PET-CT. Residual lymphoma was treated with consolidation radiotherapy (50 Gy in 25 fractions) over 5 weeks after chemotherapy. The patient attained a complete response and has been disease-free for more than 4 years. Thus, duodenal perforated lymphoma can be treated successfully using a multidisciplinary approach that combines surgery, immunochemotherapy, and radiation therapy.
ISSN:2090-6706
2090-6714
DOI:10.1155/2018/2326459