2597
INTRACRANIAL
INVOLVEMENT IN HODGKIN’S DISEASE Akyuz
C, Yalcln B, Atahan IL, Kutluk MT, Buyukpamukcu M. Depts.
of Pediatric Oncology and Radiation Oncology, Hacettepe University Faculty
of Medicine, Ankara, Turkey Objective: Intracranial involvement by Hodgkin’s disease
(HD) is quite rare and usually appears as a late complication in patients
with disseminated disease. It is frequently the result of direct extension
either from dural and/or osseous deposits or from leptomeningeal
metastases. We report three cases of HD with intracranial involvement. Patients: Among 750 HD patients followed up in our center
between 1973 and 2000, intracranial involvement occurred only in three. The
ages of the patients were 4, 12 and 15 years (two girls, one boy). Two cases
had mixed cellularity and the third had nodular sclerosing type HD. At the
time of diagnosis, treatment was planned depending on disease stages as
alternating cycles of COPP and/or ABVD chemotherapies and involved field
radiotherapy. Following initial diagnosis, intracranial involvement
occurred in these three patients in the 26th, 39th,
and 42nd months, respectively. Two patients experienced
convulsions and the other complained of diplopia prior to the detection of
cranial metastases. In these three patients, intracranial lesions were
viewed by computerized tomography or magnetic resonance imaging to be
located in the left parietal, the left parietooccipital and the right
parietal, and the right temporal regions, respectively. Histological
verification of cranial involvement of HD was performed in only one case.
All three patients were asymptomatic and free of disease following systemic
chemotherapy and external radiation therapy to the cranial lesions
(3000-4000 cGy). However, they all died with widely disseminated disease 8,
22, and 32 months after the diagnosis of intracranial recurrences,
respectively. Results: Intracranial involvement of HD is usually an
indicator of progressive disease. Although intracranial disease responds to
radiotherapy and systemic chemotherapy, the ultimate prognosis is poor in
these patients despite aggressive treatment.