Mycosis fungoides. Intraocular and central nervous system involvement

Area of Science:

• Oncology
• Ophthalmology
• Neurology

Background:

• Mycosis fungoides is a type of T-cell lymphoma primarily affecting the skin.
• Recurrent cutaneous disease often necessitates systemic treatment with chemotherapy and radiation.

Observation:

• A 58-year-old man with mycosis fungoides developed visual disturbances, neurological signs, and coma.
• Initial treatment with chemotherapy and radiation led to temporary improvement.
• Ocular relapse occurred with optic disc swelling and retinal/vitreous infiltrates, despite prior systemic therapy.

Findings:

• Histologic examination revealed extensive ocular involvement by tumor cells in the retina and vitreous.
• The central nervous system was notably free of tumor cells, suggesting treatment efficacy.
• Local ocular radiation provided transient improvement in visual symptoms.

Implications:

• This case highlights the potential for ocular and neurological complications in advanced mycosis fungoides.
• The findings suggest that while chemotherapy and radiation can impact tumor burden, they may not prevent ocular relapse.
• Further research is needed to optimize treatment strategies for preventing and managing ocular involvement in mycosis fungoides.