Sustained Complete Remission After a Single Cycle of R-CHOP in Extranodal Diffuse Large B-Cell Lymphoma of the Mandible: A Case Report

Diffuse large B-cell lymphoma (DLBCL) is an aggressive yet potentially curable malignancy when treated with standard multi-cycle R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin hydrochloride (Hydroxydaunorubicin), Vincristine sulfate (Oncovin), and Prednisolone/Prednisone) chemo-immunotherapy. Durable remission after incomplete or abbreviated therapy is exceptionally uncommon. We report the case of a 38-year-old man diagnosed with extranodal DLBCL of the mandible who received one cycle of R-CHOP before discontinuing therapy due to loss of insurance coverage. He was lost to follow-up and later re-presented with mild local symptoms. Restaging with contrast-enhanced computed tomography of the neck, chest, abdomen, and pelvis, along with magnetic resonance imaging of the brain and face, demonstrated no evidence of residual, recurrent, or disseminated disease. Laboratory studies, including complete blood count, comprehensive metabolic panel, and lactate dehydrogenase, were within normal limits. The patient has been in sustained complete clinical and radiologic remission for 24 months after a single cycle of R-CHOP. This case highlights the rarity of durable remission after minimal therapy in DLBCL and supports further investigation into biologic mechanisms associated with exceptional responses.