title: Intracranial presentation of systemic Hodgkin's disease.
abstract: Intracranial involvement by Hodgkin's disease is rare. We report a patient with Hodgkin's disease who had intracranial disease at presentation. We also review the literature pertaining to intracranial Hodgkin's disease. Using the key words "Hodgkin's disease" and "central nervous system (CNS) disease", we searched the Pubmed and Cancerlit databases. References were systematically reviewed and data regarding the following variables was extracted: age, gender, signs and symptoms at presentation, histology of Hodgkin's disease, cerebrospinal fluid analysis, stage and treatment. Only 36 cases of intracranial Hodgkin's disease were identified in the literature. Intracranial Hodgkin's disease at presentation is even more uncommon with only 8 reported cases. Most cases of intracranial involvement by Hodgkin's disease occur at the time of relapse. The most common presenting feature of intracranial Hodgkin's disease is a cranial nerve palsy with brain parenchyma being the most common intracranial site of involvement. Mixed cellularity histology is the most frequent subtype of Hodgkin's disease among these patients and the median survival following intracranial presentation is 46 months. Treatment has varied extensively but includes whole brain radiation with or without combination chemotherapy. Our literature review suggests that the prognosis is not dismal with appropriate treatment.
authors.affiliation: Department of Radiation Oncology , Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Khalid
authors.initials: K
authors.lastname: Hirmiz
authors.forename: Annette
authors.initials: A
authors.lastname: Foyle
authors.forename: Derek
authors.initials: D
authors.lastname: Wilke
authors.forename: Steven
authors.initials: S
authors.lastname: Burrell
authors.forename: Robert
authors.initials: R
authors.lastname: Brownstone
authors.forename: Casely
authors.initials: C
authors.lastname: Ago
authors.forename: Rajbir
authors.initials: R
authors.lastname: Pahil
authors.forename: Stephen
authors.initials: S
authors.lastname: Couban
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000628:therapy; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents