Doğan KÖSE, Ali Sami KIVRAK, Serdar UĞRAŞ, YAVUZ KÖKSAL

Burkitt Lenfomalı Bir Çocukta İzole Skrotal Deri Relapsı

En hızlı büyüyen insan tümörü olan Burkitt lenfoma (BL), agresif bir B hücre neoplazisidir. Genellikle ekstranodal bir hastalık şeklinde ortaya çıkar. Ekstranodal alanlara metastazı da sıktır ancak cilt tutulumu nadirdir. On bir yaşında erkek hasta, karın ağrısı ve yutma güçlüğü şikayeti ile başvurdu. Batın sol alt kadranda tespit edilen kitleye uygulanan trucut biyopsi ile BL tanısı konuldu ve BFM-95 B hücreli Non-Hodgkin lenfomu (NHL) tedavi protokolü uygulandı. Hasta tedavi bitiminden 1,5 ay sonra sağ skrotal şişlik şikayeti ile tekrar başvurdu. Fizik muayenesinde, sağ skrotal ödem ve kızarıklık vardı. Skrotum cildinden yapılan biyopsi ile hastaya relaps BL tanısı konuldu ve LMB-Grup C tedavi protokolü uygulandı. Tedavi bitiminden 20 ay sonra hasta batında şişlik ve ağrı şikâyeti ile tekrar geldi. Muayenesinde; batında sol üst-orta kadranda bir kitle saptandı. Yapılan biyopsinin sonucu yine BL olarak rapor edildi ve hastaya COPM (vinkristin, prednizolon, siklofosfamid, metotreksat) tedavi protokolü ile birlikte rituksimab başlandı. Ancak santral sinir sistemi relapsı gelişti ve hasta kaybedildi. Bu olgu daha önce literatürde izole skrotal cilt relapsı bildirilmediği için sunulmuştur

Isolated Scrotal Skin Relapse in a Child with Burkitt Lymphoma

Burkitt lymphoma (BL) that is the most rapidly growing human tumor is an aggressive B-cell neoplasia. It generally occurs as an extranodal disease. Its metastasis into extranodal areas is also frequent, however, its cutaneous involvement is rare. An 11-year-old male presented with the complaints of abdominal pain and difficulty in swallowing. The patient was diagnosed with BL by trucut biopsy that was performed for a mass identified in the left upper abdominal quadrant and B-cell Non-Hodgkin's lymphoma (NHL) BFM 95 treatment protocol was applied. The patient applied again for the complaint of right scrotal swelling 1.5 months after the completion of therapy. On physical examination, right scrotal edema and redness were identified. The patient was diagnosed with relapsed BL by biopsy taken from scrotal skin and LMB-Group C treatment protocol was applied. The patient came again with the complaints of abdominal swelling and pain 20 months after the completion of therapy. On physical examination, a mass was detected in the left mid-upper quadrant of the abdomen. The result of biopsy was reported as BL again and COPM (cyclophosphamide, vincristine, prednisolone, and methotrexate) treatment protocol and rituximab were started. However, central nervous system (CNS) relapse developed and the patient was lost. This case was presented because isolated scrotal skin relapse has not been reported in the literature

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