How would you manage a patient with a 2 cm forehead subcutaneous lesion s/p excision found to be a diffuse large B-cell lymphoma germinal center?

PET/CT negative for any other sites of metastatic disease. Focal activity noted on PET (postop changes?). CSF negative. Bone marrow biopsy negative. 2nd opinion pathology review agrees with diagnosis. No MYC, BCL2, or BCL6 rearrangements.

Answer from: Radiation Oncologist at Academic Institution

If this was known to be a DLBCL before the excision, the patient would have been recommended some variety of R-CHOP x3-4 +/- consolidative RT, given that it appears low risk IE and would've been eligible for the LYSA RCT (Lamy et al., PMID 29061568) showing only small PFS benefit (non-significant) o...

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Radiation Oncologist at University of North Carolina
I tend to rely on my pathologists placing this in ...

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How would you manage a patient with a 2 cm forehead subcutaneous lesion s/p excision found to be a diffuse large B-cell lymphoma germinal center?

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