Stage IV Breast Implant-associated Anaplastic Large-cell Lymphoma with Complete Pathologic Response to Neoadjuvant Chemotherapy.

MedStar author(s):
Citation: Plastic and Reconstructive Surgery - Global Open. 7(9):e2446, 2019 Sep.PMID: 31942403Institution: MedStar Washington Hospital Center | Washington Cancer InstituteDepartment: MedStar Regional Breast Health Program | Surgery/Plastic SurgeryForm of publication: Journal ArticleMedline article type(s): Case ReportsSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2019ISSN:
  • 2169-7574
Name of journal: Plastic and reconstructive surgery. Global openAbstract: Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is a rare lymphoma that has been associated with textured breast implants. Most cases present as a delayed (>1 year) seroma, which can be aspirated for diagnosis. Fewer patients present with masses or skin signs. Surgical resection is the cornerstone of treatment for this form of lymphoma. For advanced disease, treatment is multidisciplinary and incorporates adjuvant chemotherapy, radiation therapy, and potentially, the immunotherapeutic agent brentuximab vedotin, an anti-CD30 antibody-drug conjugate. However, relapse rates are high among patients with peripheral ALCL. We present the case of a 39-year-old woman who developed BIA-ALCL 13 years after augmentation with silicone, textured implants and had a complete pathologic response to neoadjuvant cyclophosphamide, doxorubicin (hydroxydaunomycin), vincristine (Oncovin), etoposide, prednisolone (CHOEP) at time of bilateral removal of implants and capsules. CHOEP is a long-standing regimen for treatment of peripheral ALCL and is a suggested regimen for treatment of BIA-ALCL. This case report is the first to demonstrate the use of neoadjuvant chemotherapy in the treatment of BIA-ALCL and suggests a role for its use in advanced disease. Copyright (c) 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.All authors: Fan KL, Thibodeau R, Wehner PBFiscal year: FY2020Digital Object Identifier: Date added to catalog: 2020-02-10
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Journal Article MedStar Authors Catalog Article 31942403 Available 31942403

Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is a rare lymphoma that has been associated with textured breast implants. Most cases present as a delayed (>1 year) seroma, which can be aspirated for diagnosis. Fewer patients present with masses or skin signs. Surgical resection is the cornerstone of treatment for this form of lymphoma. For advanced disease, treatment is multidisciplinary and incorporates adjuvant chemotherapy, radiation therapy, and potentially, the immunotherapeutic agent brentuximab vedotin, an anti-CD30 antibody-drug conjugate. However, relapse rates are high among patients with peripheral ALCL. We present the case of a 39-year-old woman who developed BIA-ALCL 13 years after augmentation with silicone, textured implants and had a complete pathologic response to neoadjuvant cyclophosphamide, doxorubicin (hydroxydaunomycin), vincristine (Oncovin), etoposide, prednisolone (CHOEP) at time of bilateral removal of implants and capsules. CHOEP is a long-standing regimen for treatment of peripheral ALCL and is a suggested regimen for treatment of BIA-ALCL. This case report is the first to demonstrate the use of neoadjuvant chemotherapy in the treatment of BIA-ALCL and suggests a role for its use in advanced disease. Copyright (c) 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.

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