Case 119 – Update 2

Our patient with Stage IIB Mycosis Fungoides was discussed at the relevant MDT and his care remained primarily under the dermatology and clinical oncology service. They instigated topical treatment alongside localized radiotherapy to his tumour site on the right arm. He also required systemic treatment with oral methotrexate. He responded well and achieved a good partial response (PR) with resolution of his severe itch.

2 years later he is referred urgently to haematology clinic. Several new lesions have appeared, at the original site of disease (right arm) but also on his chest wall and left ankle. These lesions initially responded to radiotherapy but recurred within a few weeks. His skin disease is less responsive to topical treatment.

He feels generally fatigued and describes unintentional weight loss over the last few months. On examination, he has nodular, ulcerating lesions in the distribution above, as well as bilateral axillary and inguinal lymphadenopathy.

Re-staging investigations demonstrate Stage IVA disease.

What treatment options would you consider?


Please reply to us (@TeamHaem) on Twitter and always include #TeamHaem to allow others to follow your comments. Please join in the debate and learn about haematological problems along the way. The case will continue to evolve over the coming week so keep checking #TeamHaem on Twitter for more information.

 Please note – all cases on TeamHaem are entirely fictional to protect patient confidentiality.

 TeamHaem are not a position of authority. It is an educational platform to allow discussion and learning.

About TeamHaem

Online education and discussion about all things haematological
This entry was posted in Uncategorised. Bookmark the permalink.