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Triple-hit high-grade B-cell lymphoma presenting with ovarian torsion
  1. Soravis Osataphan1,
  2. Aleksandra Augustynowicz2,
  3. Carmen Perrino3 and
  4. Prudence Lam4
  1. 1Department of Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, Massachusetts, USA
  2. 2Department of Radiology, Mount Auburn Hospital, Harvard Medical School, Cambridge, Massachusetts, USA
  3. 3Department of Pathology, Mount Auburn Hospital, Cambridge, Massachusetts, USA
  4. 4Department of Hematology and Oncology, Mount Auburn Hospital, Harvard Medical School, Cambridge, Massachusetts, USA
  1. Correspondence to Dr Soravis Osataphan; soravis.osataphan{at}


We report a case of a previously healthy woman in her early 70s who presented with 2 weeks of episodic abdominal pain and significant weight loss. Imaging of her abdomen revealed acute right ovarian torsion associated with bilateral ovarian enlargement and an indeterminant pelvic mass. An urgent laparoscopic bilateral oophorectomy was performed with pathological results consistent with triple-hit high-grade B-cell lymphoma. She was successfully treated with dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin and rituximab, intrathecal methotrexate and venetoclax with complete remission after three cycles. Ovarian lymphoma is a rare entity and its genetic features have not been well described. We performed a literature review, describe the current knowledge regarding ovarian lymphoma and its therapeutic implication in the genomic age.

  • haematology (incl blood transfusion)
  • gynaecological cancer

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  • Contributors SO and AA were responsible for drafting of the case write up. CP and PL provided critical review of the report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.