Key result
Surgical debulking plus DA-EPOCH-R relieves SVC syndrome in a massive primary mediastinal large B-cell lymphoma case.
Why the study?
Massive primary mediastinal large B-cell lymphoma tumors may occasionally cause life-threatening cardiopulmonary compromise and diagnostic uncertainty despite systemic immunochemotherapy being standard treatment.
Case Report (n=1)
No
While systemic immunochemotherapy is the standard of care for primary mediastinal large B-cell lymphoma, surgical debulking can be a crucial and effective intervention for exceptional cases presenting with critical cardiopulmonary compression and diagnostic uncertainty.
Should not yet change practice in PMBCL; leaves open surgical debulking for rare cases with critical compression and diagnostic uncertainty.
Primary mediastinal large B-cell lymphoma (PMBL) is a distinct clinicopathologic entity that typically presents as an anterior mediastinal mass in young adults. Although systemic immunochemotherapy is the cornerstone of treatment, massive tumors may occasionally cause life-threatening cardiopulmonary compromise and diagnostic uncertainty. We report the case of a 30-year-old man who presented with superior vena cava syndrome due to a giant mediastinal mass. Because of imminent cardiopulmonary risk and the inability to obtain a definitive diagnosis using minimally invasive techniques, surgical debulking was performed. Histopathological and immunohistochemical evaluation established the diagnosis of PMBL.
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Iliev et al. (2026) conducted a case report in primary mediastinal large B-cell lymphoma (PMBL) (n=1). surgical debulking followed by systemic chemotherapy with dose-adjusted EPOCH-R was evaluated on definitive histopathological diagnosis and symptom relief from superior vena cava syndrome. Surgical debulking followed by dose-adjusted EPOCH-R chemotherapy enabled definitive diagnosis and symptom relief in a 30-year-old man with massive primary mediastinal large B-cell lymphoma causing superior vena cava syndrome.
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