Rare Tumors · Published 2026-07-01 · DOI 10.1177/20363613261443114
Oscar Alvarez-Palacios, Luis Ojeda-Campos, Alfredo Rodríguez, Gabriel Ernesto Díaz-Juarez, José Manuel Figueroa-Torres, Rocío Juárez-Velázquez, Ulises Juárez-Figueroa, Jorge Johans Gallardo-Navarro, Luis Fabian Segundo-Galvez, Azucena Ocampo-Bárcenas
Second malignant neoplasms (SMNs) are rare but serious late effects in childhood acute lymphoblastic leukemia (ALL) survivors. Mature peripheral T-cell lymphomas involving both the breast and ovary are exceedingly rare, and their relationship with germline predisposition variants remains poorly understood. We report a 17-year-old female, previously treated for high-risk B-cell ALL and in sustained remission, who developed bilateral breast and ovarian masses in 2024. Histopathology and immunohistochemistry confirmed a mature T-cell lymphoma (CD7 + , CD99 + , weak CD5/CD3, Ki-67 >90%, TdT – ). Whole-exome sequencing revealed a germline pathogenic BRCA2 variant (c.1910-2A>T) along with additional likely pathogenic variants ( CUX1 , MED12L , POLR3B , PIK3CA ). The disease progressed rapidly despite CHOP chemotherapy, and the patient died shortly after diagnosis. This report describes an exceptionally rare SMN of peripheral T-cell lymphoma with breast and ovarian involvement in a pediatric leukemia survivor. The coexistence of a germline BRCA2 mutation and additional genomic alterations suggests a multigenic predisposition hypothesis. Early incorporation of next-generation sequencing may uncover molecular vulnerabilities and inform alternative therapeutic strategies in refractory hematologic malignancies.
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Alvarez-Palacios, O., Ojeda-Campos, L., Rodríguez, A., et al. (2026). T-cell lymphoma of the breast and ovary presenting as a second malignant neoplasm in a pediatric leukemia survivor: A case report and literature review. Rare Tumors. https://doi.org/10.1177/20363613261443114