Recurrent mediastinal mass in a child with Hodgkin's disease following successful therapy: a diagnostic challenge.
The case of an 11-year-old girl with mediastinal stage III B-E Hodgkin's disease is described. She achieved complete remission with combined chemoradiotherapy according to the Swiss Pediatric Oncology Group-HD Protocol 1985. Six months after all therapy was stopped, a slowly growing retrosternal mass was detected. Computed tomography (CT) and gallium-67 single-photon emission CT (SPECT) could not elucidate the true origin of the tumor, nor did ultrasound-guided transthoracic fine-needle puncture. Open biopsy with histologic examination of the lesion has successfully identified the mass as thymic hyperplasia, a rebound immunologic reaction after chemoradiotherapy that mimicked tumor regrowth.
Feldges
A
A
Ostschweizerisches Kinderspital, CH-9006 St. Gallen, Switzerland.
Wagner
H P
HP
Bubeck
B
B
Kehrer
B
B
Ries
G
G
Schmid
U
U
Waibel
P
P
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001707:Biopsy, Needle; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000532:radiotherapy; D006801:Humans; D008479:Mediastinal Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000532:radiotherapy; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D018714:Radiotherapy, Adjuvant; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed