Dados do Trabalho

Título

Bilateral breast MALT lymphoma: a case report and review of the literature

Apresentação do caso

S.S.M. is a 55-year-old woman who had been consulting with gynecologist for 5 year regarding a single left breast nodule. In october 2020 was subjected to core biopsy guided by ultrasound which diagnosed MALT lymphoma. In order to stage disease she underwent a PET scan in january 2021 that showed a 2cm nodule (SUV max 2,6) on the upper inner quadrant of the right breast and a 3,5cm nodule (SUV max 3,8) at 6 hours of the left breast. Having histopathologycal confirmation of MALT lymphoma on both lesions was then staged as IE and reffered to radiotherapy.She was treated with exclusive radiation therapy to both breasts with conformacional radiotherapy, conventional fractionation of 2Gy/day, and a total dose of 40Gy.

Discussão

Breast lymphoma is a rare disease. Both primary and secondary breast involvement have been reported. Most primary breast lymphomas are high-grade malignant neoplasms, mainly large cell and Burkitt type. Low-grade lymphomas of the breast, particularly mucosa-associated lymphoid tissue (MALT) lymphomas, have been exceedingly rare. Breast MALT lymphomas account for a small fraction of all the MALT lymphomas (1–2%). In this report we present a patient with bilateral breast involvement by MALT lymphoma. She was treated with exclusive radiotherapy to both breasts, had a very good cosmetic result with well tolerated toxicities. The patient is alive and well 3 months after therapy with no recurrence.

Comentários Finais

It is difficult to make any definitive conclusions regarding treatment guidelines. The natural history and the optimal management of MALT lymphomas of the breast are not well outlined due to limited experience with this entity. However, these lymphomas are distinct from the non-MALT lymphomas of the breast by virtue of their indolent clinical behavior and prolonged disease-free survival. This localization of MALT lymphoma in two or more sites for a lengthy period of time is characteristic of the biological behavior of this type of lymphoma. Althought the literature shows more case reports that were treated with surgery (either surgery alone or surgery in addition to chemotherapy, radiation therapy, or both), than chemotherapy alone, than radiotherapy alone. Of those that received definitive radiotherapy, there is no report of one that died from progressive disease to the date. We still wait for long term follow up for more consistent conclusions of clinical control of the disease.

Palavras-chave

MALT, BILATERAL BREAST CANCER, LYMPHOMA