Unprecedented remission with radiotherapy alone: A rare case of mutilating scalp recurrence of Hodgkin's lymphoma with preexisting chronic liver disease

Abstract

Recurrence of Hodgkin's lymphoma in the scalp is extremely rare (only one such case reported, way back in 1970) and its treatment in the setting of chronic liver disease is unknown. We hereby report the second case of recurrent Hodgkin's lymphoma of the scalp, in a 28-year-old male, presenting as a mutilating ulcer over the entire right hemicranium with autoamputation of the right pinna. He was unfit for chemotherapy in view of his preexisting chronic liver disease and was therefore treated with radiotherapy alone, to the dose of 40 Gy in 20 fractions over 4 weeks in conventional fractionation, using Tele-Cobalt 60, leading to complete and sustained remission (at 5 years follow up) and unprecedented organogenesis of the scalp and the pinna.