Coexistence of Mycosis Fungoides and Hodgkin Lymphoma in a Pediatric Patient: A Report of a Rare Case.
This case report describes a 12-year-old with stage IA mycosis fungoides and synchronous stage IVB Hodgkin lymphoma who achieved complete remission after sequential pembrolizumab-containing chemotherapy, additional multiagent chemotherapy, and radiotherapy.
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This case report describes a 12-year-old with stage IA mycosis fungoides and synchronous stage IVB Hodgkin lymphoma who achieved complete remission after sequential pembrolizumab-containing chemotherapy, additional multiagent chemotherapy, and radiotherapy.
Research significance
The reported remission provides a preliminary human signal that a pembrolizumab-containing regimen may be feasible within multimodal treatment of synchronous pediatric mycosis fungoides and Hodgkin lymphoma; however, any specific contribution from checkpoint blockade is inferential because several chemotherapy regimens and radiotherapy were administered sequentially.
Source abstract
Mycosis fungoides (MF) is the most common primary cutaneous T‑cell lymphoma, usually affecting adults aged 50-60 years; pediatric presentation is rare. We report a 12‑year‑old patient whose course spanned five years; skin lesions began at age 8, were misdiagnosed and treated as inflammatory dermatosis with topical steroids for four years. At age 12, B‑symptoms, lymphadenopathy and organomegaly led to the diagnosis of MF Stage IA (T1bNxM0B0) and synchronous Hodgkin lymphoma (HL) Stage IVB, with an Epstein-Barr virus (EBV) viral load of 2.5 log₁₀ copies/mL. Treatment with three cycles of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) + pembrolizumab due to drug availability, followed by six cycles of PC‑AVBE (prednisone, cyclophosphamide, doxorubicin, vincristine, bleomycin, and etoposide) and radiotherapy, achieving complete remission. This case highlights diagnostic challenges, immune dysregulation, and adapted treatment in resource‑limited settings.