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Open Access Case report

Incidental advanced-stage Hodgkin lymphoma diagnosed at the time of radical prostatectomy for prostatic cancer: a case report and review of literature

Antonio Di Meglio12*, Pier Vitale Nuzzo12, Francesco Ricci2, Bruno Spina3 and Francesco Boccardo12

Author Affiliations

1 IRCCS San Martino University Hospital, IST National Cancer Research Institute, Academic Unit of Medical Oncology, Genoa, Italy

2 Department of Internal Medicine (DiMI), University of Genova School of Medicine, Genoa, Italy

3 IRCCS San Martino University Hospital, IST National Cancer Research Institute, Histopathology and Cytology Unit, Genoa, Italy

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BMC Cancer 2014, 14:613  doi:10.1186/1471-2407-14-613

Published: 26 August 2014

Abstract

Background

Pelvic lymph nodes removed during radical retropubic prostatectomy for prostatic cancer can be found on pathological examination to harbor various unexpected pathologies. Among these, hematologic neoplasms are not infrequent. Given their frequently indolent clinical course, such neoplasms would likely have remained undiagnosed and non-life threatening. Despite this, the case we are reporting describes a rare association between two aggressive neoplasms, and it will be helpful to clinicians who encounter similar combinations of pathologies.

Case presentation

We report the challenging case of a 56-year-old, caucasian man in whom pathological assessment of pelvic lymph nodes removed during radical retropubic prostatectomy for a high-grade prostatic neoplasm revealed Hodgkin lymphoma, which was subsequently classified as stage IV. There are very few published reports of this combination of pathologies. This situation required a cautious and expert approach to delivering the most appropriate treatment with the most appropriate timing for both diseases.

Conclusion

This report describes the multidisciplinary clinical approach we followed at our institution. We have also presented a review of published reports concerning the incidence, histologic type, and management of such concurrent malignancies.

Keywords:
Prostatic neoplasm; Radical prostatectomy; Hodgkin lymphoma; Hematologic neoplasm; Concurrent malignancies; CD44; Literature review