Institutional review of pelvic lymphoma: A 24-year experience

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6702 Background: The manifestation of lymphoma as a pelvic mass is rare with most previous literature reporting a poor prognosis. Our objective is to report our experience with this rare gynecologic malignancy. Methods: Retrospective review was performed on patients (pts) diagnosed with lymphoma of the gynecologic organs between 1980 and 2004. Medical records, diagnostic imaging and pathology reports were reviewed. Histologic classification was based on the Working Formulation and staging on the Ann Arbor system. Results: 19 pts with diagnosis of pelvic lymphoma (PL) were identified. 18 of these presented as primary lymphomas of gynecologic organs. Location of pelvic mass included ovarian (11), uterine (2), vaginal (2), uterine and ovarian (1), vaginal and cervical (1). The median age at presentation was 53 yrs (19–87). Eleven percent presented as stage I, 5% stage II, 5% stage III, and 79% stage IV. Presentations included abdominal and pelvic discomfort and bloating (32%), abnormal vaginal bleeding (11%), fever/night sweats (11%). 7 pts were asymptomatic (37%). 6 cases were identified as incidental findings (3 cases were identified during workup for concomitant endometrial cancer). PL phenotype was B cell (100%) with diffuse cell (64%) and follicular/mixed (11%) as most common histologic subsets. Combination chemotherapy was administered to 17 pts, with additional radiation therapy in 2 and stem cell treatment in 2. Four pts were diagnosed within the last 6 months and are alive and undergoing treatment. In the remaining 15 pts, median follow-up time was 36 months (m) (6–247). Overall median survival in this group was 36 m (6–247), 11 are alive with no evidence of disease (NED). Three of the primary pelvic lymphomas have recurred (one brain, one bone, and one lung/bone). All three patients are deceased; their median survival from initial diagnosis was 17 m (9–47) and 6 m (2–6) from recurrence. The one patient with known lymphoma and an ovarian recurrence is alive with NED 48 m after diagnosis. Conclusion: We present one of the largest single institution experiences with PL. While previous studies have reported a poor outcome, we demonstrate a more favorable prognosis. With appropriate diagnosis PL can be managed successfully with histologic specific chemotherapy. No significant financial relationships to disclose.