PMC3999579_01
Total lymphoid irradiation with a cobalt-60 unit. The subdiaphragmal field configuration consisted of an inverted Y field including the retroperitoneal, iliac and inguinal lymph nodes. Treatment planning included a lymphography with lipiodol. At the left hilum of the kidney, pathological lymph nodes were visible; they received an additional boost dose.
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F1
Hodgkin's lymphoma (CSIIIA), the patient was 15 years of age (fig. 1). He received total lymphoid irradiation with a cobalt-60 unit.
PMC3999579_02
Myxoid tumor tissue with cell whorls herniating rarely into the vascular lumina (HE, original magnification: x100).
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F2
There were foci of chondroid differentiation (fig. 2, fig. 3).
PMC3999579_03
Coronal T1-weighted MRI scan revealing the recurrent disease. An extensive tumor (10 x 5 x 6 cm) expanding from the left sciatic nerve to the gluteal region.
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F4
Two months after the microsurgical operation, the tumor had regrown up to 9.9 x 4.7 x 5.9 cm (fig. 4).
PMC3999579_04
The dose distribution of the radiotherapy treatment planning: yellow indicates the 95% isodose of the prescribed dose of 50.4 Gy, red indicates the 95% isodose of the prescribed boost dose of 64.8 Gy - representing an additional boost to the region of the recurrent tumor.
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F5
The loco-regional metastases received an additional boost dose of 14.4 Gy, resulting in a cumulative dose of 64.8 Gy (fig. 5).