| A case of Second Malignant Neoplasm Complicating Hodgkin's Disease in Remission. |
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Hong Hoe Koo1, Jong Woon Choi1, Sang Oh Na1, Il Soo Ha1, Hee Young Shin1, Hyo Seop Ahn1, Yeon Lim Suh2, Chul Woo Kim2, Je Geun Chi2 |
1Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
2Department of Pathology, College of Medicine, Seoul National University, Seoul, Korea |
| 완해된 Hodgkin병에서의 이차성 악성종양 1례 |
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구홍회1, 최종운1, 나상오1, 하일수1, 신희영1, 안효섭1, 서연림2, 김철우2, 지제근2 |
1서울대학교 의과대학 소아과학교실
2서울대학교 의과대학 병리학교실 |
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Received: 3 September 1989 • Accepted: 17 October 1989 |
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| Abstract |
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Recent advances in the treatment of cancer have resulted in increased survival and possible cure for
many malignant disorders, particularly childhood cancers. There has been a marked improvement in
the treatment of childhood Hodgkin’s disease, and five-year survival rates for even advanced stages
of Hodgkin’s disease approach or exceed more than 75% with modern treatment policies. However,
successful therapy in childhood cancer is frequently associated with second malignant neoplasm and
the 20-year cumulative probability percentage of a second cancer was predicted as 12%. The
occurrence of sarcoma as a late consequence of ionizing irradiation, although rare, is a well-
documented phenomenon. Malignant fibrous histiocytoma is a recently recognized tumor which is
composed of bizzare fibroblasts, histiocytes, and giant cells with a storiform fibrous stroma.
We have experienced a case of radiation-induced malignant fibrous histiocytoma in treated
Hodgkin’s disease. At 13 years of her age she was diagnosed as Hodgkin’s disease and managed by
C-MOPP regimen for 6 cycles followed by radiotherapy (4,075 cGy) after remission. Four years and
seven months after radiotherapy, a mass was noted on the scapular area which was within the field
of radiation. Four months after excisional biopsy which was done at local hospital she received
chemotherapy for 5 months. During chemotherapy a mass was found on the same site. At the second
excisional biopsy, a 4x3.5x1.2 cm sized pinkish gray soft tissue mass was removed. Immunohisto-
chemical study with al -antichymotrypsin staining revealed a strong positivity in the cytoplasm of
tumor cells indicating the histiocytic origin. She received chemotherapy for 3 months. Thereafter she
was lost to follow-up and expired at home 30 months after diagnosis of second malignant neoplasm.
A brief review of the literature was made. |
| Key Words:
Second Malignant Neoplasm, Hodgkin’s disease, Malignant Fibrous Histiocytoma |
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