Enigmatic Presentation of Primary Cutaneous Lymphoma in a Boy

Primary cutaneous follicle center lymphoma (PCFCL) is a subtype of primary cutaneous B-cell lymphoma. It is exceedingly rare in the pediatric population, with less than two dozen cases documented in individuals younger than 20 years. The rarity of the disease, coupled with the scarcity of comprehensive clinical data, emphasizes the importance of a meticulous approach in the diagnostic process to avoid under-diagnosis or misdiagnosis.

We report a case of an eight-year-old boy who presented with a unique form of scalp lesion, ultimately diagnosed as PCFCL. A complete excision of the remaining defect was addressed by a rotational flap based on the superficial temporal artery.

Adopting a multidisciplinary approach in managing PCFCL in the pediatric age group exemplifies the importance of collaborative care in addressing complex and rare conditions. The favorable outcome post surgical intervention reinforces the role of complete excision in treating localized PCFCL, aligning with current treatment guidelines for this patient demographic.

The management of pediatric PCFCL consists of complete surgical excision as the primary treatment modality, reserving radiotherapy for cases of relapse. This case adds to the scant literature on pediatric primary cutaneous B-cell lymphoma and highlights this rare entity's diagnostic challenges and clinical peculiarities. Ongoing research is essential to enhance our understanding, refine diagnostic criteria, and develop more effective treatment protocols for PCFCL.