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Total skin electron therapy as treatment for epitheliotropic lymphoma in a dog

Santoro, Domenico, Kubicek, Lyndsay, Lu, Bo, Craft, William, Conway, Julia
Veterinary dermatology 2017 v.28 no.2 pp. 246
adults, alopecia, dogs, drug therapy, electrons, histopathology, ichthyosis, mycosis fungoides, relapse, remission
BACKGROUND: Mycosis fungoides (MF) is an uncommon cutaneous neoplasm in dogs. Treatment options are limited. Total skin electron therapy (TSET) has been suggested as a possible therapy for canine MF. OBJECTIVE: To describe the use of TSET as palliative treatment for MF in a dog. RESULTS: An adult dog, previously diagnosed with nonepidermolytic ichthyosis, was presented with generalized erythroderma, alopecia and erosions. Histopathology revealed a densely cellular, well‐demarcated, unencapsulated infiltrate extending from the epidermis to the mid‐dermis compatible with MF. The infiltrate exhibited epitheliotropism multifocally for the epidermis, infundibula and adnexa. Due to a lack of response to chemotherapy, TSET was elected. Six megavoltage electrons were delivered using a 21EX Varian linear accelerator. A dose of 6 Gy was delivered to the skin surface and a 100 cm skin to surface distance was used for dog setup. The treatment time for the cranial half treatment was 3 h. The treatment was divided in two sessions (cranial and caudal halves of the body) 15 days apart. Clinical and histopathological complete remission was achieved and the dog was kept in remission with no additional treatments for 19 months before relapse and development of Sézary syndrome. CONCLUSION AND CLINICAL SIGNIFICANCE: To the best of the authors’ knowledge, this is the first case reporting the use of TSET for medically refractory canine MF with post treatment follow‐up. This case suggests that the use of TSET may be an effective palliative treatment for canine MF.