Journal of the Korean Pediatric Society 1990;33(4):564-572.
Published online April 30, 1990.
A case of Second Malignant Neoplasm Complicating Hodgkin's Disease in Remission.
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
구홍회1, 최종운1, 나상오1, 하일수1, 신희영1, 안효섭1, 서연림2, 김철우2, 지제근2
1서울대학교 의과대학 소아과학교실
2서울대학교 의과대학 병리학교실
Received: 3 September 1989   • Accepted: 17 October 1989
Abstract
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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