case_images: PMC3999579_01
case_images: 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.
case_images: cro-0007-0239-g01.jpg
case_images: PMC3999579_01_cro-0007-0239-g01.jpg
case_images: F1
case_images: Hodgkin's lymphoma (CSIIIA), the patient was 15 years of age (fig. 1). He received total lymphoid irradiation with a cobalt-60 unit.
case_images: PMC3999579_02
case_images: Myxoid tumor tissue with cell whorls herniating rarely into the vascular lumina (HE, original magnification: x100).
case_images: cro-0007-0239-g02.jpg
case_images: PMC3999579_02_cro-0007-0239-g02.jpg
case_images: F2
case_images: There were foci of chondroid differentiation (fig. 2, fig. 3).
case_images: PMC3999579_03
case_images: 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.
case_images: cro-0007-0239-g04.jpg
case_images: PMC3999579_03_cro-0007-0239-g04.jpg
case_images: F4
case_images: Two months after the microsurgical operation, the tumor had regrown up to 9.9 x 4.7 x 5.9 cm (fig. 4).
case_images: PMC3999579_04
case_images: 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.
case_images: cro-0007-0239-g05.jpg
case_images: PMC3999579_04_cro-0007-0239-g05.jpg
case_images: F5
case_images: The loco-regional metastases received an additional boost dose of 14.4 Gy, resulting in a cumulative dose of 64.8 Gy (fig. 5).