Intracranial Hodgkin's disease

Abstract

Intracranial deposits are rare in Hodgkin's disease. When this complication does occur, it is usually seen in patients who have relapsed with widespread disease. We report two patients with Hodgkin's disease who developed cerebral deposits. In one patient it was a terminal event. In the other it was apparently the only site of relapse. A man aged 22 years presented in January 1979 with a 3- year history of an enlarged gland in the right axilla. He had no “B” symptoms. On examination he had enlarged nodes in the right axilla and on both sides of the neck. A chest radiograph showed no abnormality. Biopsy of an axillary node showed nodular sclerosing Hodgkin's disease. A lymphogram was normal but at staging laparotomy he was found to have involvement of a coeliac node and of the spleen. The final pathological staging was IIIAs. Chemotherapy using the MOPP regime was started, but after completing three cycles he was not in remission, so it was decided to use radiotherapy in addition. Treatment to the cervical, axillary, mediastinal and upper para-aortic nodes was given using the “mantle” technique. He received a dose of 3800 cGy in 16 fractions over a period of 4 weeks to these areas. Chemotherapy using MOPP was continued after this treatment.