Synchronous diffuse large B-cell lymphoma and gynecological malignancy treated with paclitaxel and carboplatin: A...

Diffuse large B-cell lymphoma (DLBCL) can occur at various sites and is rarely diagnosed as synchronous multiple primary malignancies. A treatment approach for this synchronous malignancy has not been established. Here, we report two cases of synchronous DLBCL and gynecological malignancy treated with the paclitaxel and carboplatin (TC) regimen. Patient #1: A 67-year-old female presented with right axillary lymphadenopathy. A computed tomography (CT) revealed a hepatic mass and an ovarian tumor. Biopsy of the lymphadenopathy diagnosed DLBCL (stage I). Ovarian and peritoneal biopsies confirmed ovarian cancer (stage IVB, peritoneal dissemination, and liver metastasis). She received 6 cycles of TC chemotherapy for ovarian cancer, followed by surgery (pT3cN0M1) and an additional 2 cycles of TC. A complete metabolic response (CMR) of both malignancies was confirmed 1 year later. Patient #2: A 77-year-old female presented with left knee discomfort. Biopsy of a left femoral tumor diagnosed DLBCL (stage I). PET-CT revealed abnormal fluorodeoxyglucose uptake in the left femur and in the uterus, with an endometrial biopsy confirming endometrial cancer. She received radiation therapy for DLBCL, followed by surgery for endometrial cancer (pT1bNxM0). Postoperatively, 6 cycles of TC chemotherapy were performed, and she achieved a CMR. No Grade 3/4 nonhematologic adverse events were observed in both patients. In conclusion, the TC regimen was safely administered in our two patients. In one of them, TC therapy alone was effective for DLBCL. The clinical courses may provide a valuable reference for the management of similar patients.