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A Vanishing Lymphoma in the Cheek

Background: We describe the unusual case of a 66-year-old woman who presented with a cheek mass that completely abated with oral steroids. Case Report: Multiple separate biopsies of the mass were negative or inconclusive. MRI revealed a large mass, yet after a short steroid course, this mass was completely undetectable on clinical examination. A repeat biopsy eventually revealed follicular lymphoma. Discussion: Lymphomas are known to be steroid sensitive; the medication is an essential component of the common CHOP therapy. While known to occur in the central nervous system, to the best of our knowledge, the presence of a ‘vanishing' lymphoma has not been documented in the head and neck. We discuss the likely physiology of the vanishing lymphoma, and the diagnostic difficulty it presents. Conclusion: When a lymphoma is suspected, patient care may be optimized if biopsy is delayed until steroids have been discontinued.