scholarly journals Recurrent Hodgkin’s Disease Presenting as a Clinically Isolated Cavernous Sinus Syndrome

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Aayesha Jalaluddin Soni ◽  
Edward Bernard Lee-Pan
Keyword(s):  
Cavernous Sinus ◽  
Hodgkin's Disease ◽  
Clinical Presentation ◽  
Recurrent Disease ◽  
Hodgkin’S Disease ◽  
Systemic Disease ◽  
Disease Process ◽  
Signs And Symptoms ◽  
Excisional Biopsy ◽  
Cavernous Sinus Syndrome

Background. Hodgkin’s disease involving the central nervous system is uncommon and is usually seen in patients with uncontrolled systemic disease or those who have had multiple episodes of recurrent disease. Common symptoms of intracranial Hodgkin’s disease are motor and/or sensory deficits, headache, papilloedema, coma, and seizures. The rarity of Hodgkin’s disease presenting with intracranial involvement is marked, but patients presenting with cavernous sinus syndrome is even rarer. Despite its rarity, the presence of a cavernous sinus syndrome in a patient with a known history of Hodgkin’s disease warrants full utilization of modern diagnostic techniques in terms of investigation. Case Presentation. A 34-year-old woman, known with previous Hodgkin’s lymphoma and now in remission for the past 7 years, presented with signs and symptoms suggestive of a left cavernous sinus syndrome. She was otherwise systemically well with no other complaints. Extensive investigations revealed no obvious cause for the cavernous sinus syndrome. A CT chest revealed subclinical axillary lymphadenopathy, which on excisional biopsy confirmed recurrent Hodgkin’s disease. The patient’s sole clinical presentation of her recurrent disease was the cavernous sinus syndrome, with no other clinically obvious systemic signs or symptoms to suggest a relapse. This was treated with steroids, and clinical improvement was noted; she was referred to oncology for extensive chemotherapy. Conclusions. Whilst there is a paucity of literature around this topic, it must be remembered by the clinician that cavernous sinus syndrome may be the sole clinical presentation of recurrent Hodgkin’s disease. Even though it is reported that lymphomatous involvement in the brain usually occurs late in the disease process, this case is evidence that cavernous sinus syndrome may precede other systemic signs and symptoms. Recognising this possibility will ensure a rigorous search for Hodgkin’s disease, an early and effective diagnosis, and a better prognosis in affected patients.

Acute hypersensitivity reactions to etoposide in a VEPA regimen for Hodgkin's disease.

1993 ◽  
Vol 11 (6) ◽  
pp. 1080-1084 ◽  
Author(s):  
M M Hudson ◽  
H J Weinstein ◽  
S S Donaldson ◽  
C Greenwald ◽  
L Kun ◽  
...  
Keyword(s):  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Signs And Symptoms ◽  
Allergic Reactions ◽  
Hypersensitivity Reactions ◽  
Newly Diagnosed ◽  
Intravenous Contrast ◽  
Respiratory Problems ◽  
High Incidence ◽  
Intravenous Contrast Media

PURPOSE We report an unexpectedly high incidence of hypersensitivity to etoposide among 45 patients with newly diagnosed Hodgkin's disease treated with vinblastine, etoposide, prednisone, and doxorubicin (VEPA) plus radiation. PATIENTS AND METHODS Twenty-three of 45 patients (51%) had one or more acute hypersensitivity reactions to etoposide administration. The 23 patients were 8 to 18 years of age (median, 15 years); 12 were males. Four patients had experienced prior allergic reactions to antibiotics or intravenous contrast media. RESULTS Hypersensitivity reactions followed the first or second dose of VEPA in most cases. The reactions occurred at a median time of 5 minutes (range, 3 to 120) from the start of the etoposide infusion. Fifteen patients reacted early (within 10 minutes), four midway through the infusion, and four after completion of the infusion. Signs and symptoms included flushing, respiratory problems, changes in blood pressure, and abdominal pain with or without nausea and vomiting. Respiratory problems included dyspnea, chest pain/tightness, bronchospasm, and cyanosis. Symptoms were alleviated by discontinuing the etoposide infusions and administering diphenhydramine and/or hydrocortisone; epinephrine was required to reverse bronchospasm in three cases. All 23 patients recovered without adverse sequelae and were rechallenged with etoposide. Fifteen patients tolerated subsequent etoposide infused at a slower rate, with antihistamine and/or corticosteroid premedication; five had recurrent hypersensitivity despite these measures. Three of these five developed similar symptoms when teniposide was substituted for etoposide. Three patients who had isolated episodes of hypotension on completion of the etoposide infusion successfully received subsequent infusions without premedication or change in infusion rate or concentration. CONCLUSION Despite this unexpectedly high incidence of hypersensitivity among Hodgkin's disease patients treated with etoposide, rechallenge with the drug was successful in 78% of cases.

Second solid malignancies after combined modality therapy for Hodgkin's disease.

1995 ◽  
Vol 13 (8) ◽  
pp. 2016-2022 ◽  
Author(s):  
R Doria ◽  
T Holford ◽  
L R Farber ◽  
L R Prosnitz ◽  
D L Cooper
Keyword(s):  
Solid Tumors ◽  
Hodgkin's Disease ◽  
Recurrent Disease ◽  
Hodgkin’S Disease ◽  
Combined Modality Therapy ◽  
Disease Group ◽  
Solid Malignancies ◽  
Group A ◽  
The Difference ◽  
Group B

PURPOSE To determine the actuarial incidence (AI) and relative risk (RR) of second solid malignancies (SSM; solid tumors and non-Hodgkin's lymphoma) in patients with Hodgkin's disease who were treated with chemotherapy and adjuvant, low-dose radiation (combined modality therapy; CMT). PATIENTS AND METHODS From 1969 to 1983, 102 patients with previously untreated advanced Hodgkin's disease (group A) and 81 patients with recurrent disease after radiation (group B) were treated with CMT. Patients were observed for the development of solid tumors (ST) and non-Hodgkin's lymphoma (NHL), and the AI and RR were calculated. RESULTS Nearly half of the patients entering remission were observed for greater than 15 years. At 20 years, the AI for SSM was 12% in group A versus 41% in group B (P = .009). The overall RR for developing a ST in group A was 1.88 (not significant) versus 8.84 in group B (95% confidence interval, 5.3 to 15.4). The difference in the RR between groups A and B was significant (P < .001). The RR for developing NHL was significantly increased in both groups, but the difference between groups was not significant. CONCLUSION Previously untreated patients with advanced disease who were treated with CMT (group A) had a modest but not significant increase in the RR of ST; however, patients treated with CMT for recurrent disease (group B) had a highly significant increase in the RR of ST. Possible explanations for the increase in ST in group B include more cumulative radiation or a greater carcinogenic effect of chemotherapy in previously irradiated patients, but it also is possible that the increase is due to a longer follow-up time.

Primary Cutaneous Hodgkin's Disease with Evolution to Systemic Disease

1996 ◽  
Vol 20 (6) ◽  
pp. 754-759 ◽  
Author(s):  
Shimareet Kumar ◽  
Douglas W. Kingma ◽  
William B. Weiss ◽  
Mark Raffeld ◽  
Elaine S. Jaffe
Keyword(s):  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Systemic Disease

scholarly journals Meningeal carcinomatosis in solid tumors

2011 ◽  
Vol 69 (6) ◽  
pp. 973-980 ◽  
Author(s):  
Sandro José Martins ◽  
Carla Rameri Alexandre Silva de Azevedo ◽  
Ludmilla Thomé Domingos Chinen ◽  
Marcelo Rocha Sousa Cruz ◽  
Marcos Aurélio Peterlevitz ◽  
...  
Keyword(s):  
Solid Tumors ◽  
Malignant Disease ◽  
Progressive Disease ◽  
Clinical Presentation ◽  
Systemic Disease ◽  
Performance Status ◽  
Signs And Symptoms ◽  
Intrathecal Chemotherapy ◽  
Meningeal Carcinomatosis ◽  
Late Event

The involvement of the leptomeninges by metastatic tumors can be observed in solid tumors, in which case it is termed meningeal carcinomatosis (MC), and in lymphoproliferative malignant disease. It is more common in breast and lung cancer, as well as melanoma, with adenocarcinoma being the most frequent histological type. MC is usually a late event, with disseminated and progressive disease already present and, it is characterized by multifocal neurological signs and symptoms. Diagnosis is based on the evaluation of clinical presentation, cerebrospinal fluid and neuroimaging studies. The better systemic disease control is observed with new therapeutic agents, and the development of neuroimaging methods is responsible for the increasing incidence of such metastatic evolution. Intrathecal chemotherapy is generally the treatment of choice, although frequently palliative. Prognosis is guarded, although a higher performance status may indicate a subgroup of patients with a more favorable outcome.

The management of localized, infradiaphragmatic Hodgkin's disease: Experience of a rare clinical presentation at St Bartholomew's Hospital

1984 ◽  
Vol 2 (4) ◽  
pp. 349-357 ◽  
Author(s):  
M. S. Dorreen ◽  
P. F. M. Wrigley ◽  
A. E. Jones ◽  
W. S. Shand ◽  
A. G. Stansfeld ◽  
...  
Keyword(s):  
Hodgkin's Disease ◽  
Clinical Presentation ◽  
Hodgkin’S Disease ◽  
Disease Experience

Clinical correlates of distinct immunophenotypic and histologic subcategories of lymphocyte-predominance Hodgkin's disease.

1990 ◽  
Vol 8 (12) ◽  
pp. 1959-1965 ◽  
Author(s):  
A Tefferi ◽  
R A Zellers ◽  
P M Banks ◽  
T M Therneau ◽  
J P Colgan
Keyword(s):  
B Cell ◽  
Hodgkin's Disease ◽  
Clinical Characteristics ◽  
Clinical Presentation ◽  
Hodgkin’S Disease ◽  
Cell Phenotype ◽  
Male Predominance ◽  
Clinical Correlates ◽  
Significant Difference

Histologic and paraffin immunohistologic studies were carried out on 32 patients with lymphocyte-predominance Hodgkin's disease (LPHD) seen from 1970 through 1982. While nodular histology was accurately predictive of B-cell phenotype (Leu M1 -/L26+), diffuse histology corresponded to either B-cell or Hodgkin's (Leu M1 +/L26-) phenotype, not invariably predictable even when attention was paid to subtle paragranuloma cytology. Clinical characteristics were compared between histologic (diffuse v nodular) and immunophenotypic (Leu M1 +/L26-, Hodgkin's phenotype, v Leu M1 -/L26+, B-cell phenotype) subgroups. Ten patients have since died, and the median follow-up of the living patients was 14 years (range, 6 to 31). Of the several clinical parameters compared, only axillary nodal presentation was strongly associated with both B-cell phenotype and nodular histology, while male predominance related more to B-cell phenotype than nodular histology. No significant difference in overall survival or relapse rate was apparent among either the histologic or the immunophenotypic subgroups. However, very late but salvageable relapses were associated with nodular histology. The incidences of secondary malignancies and death from Hodgkin's disease (HD) were also comparable between the subgroups. Although difference in clinical presentation may exist, neither the histologic nor the immunophenotypic subcategories of LPHD could be demonstrated to correlate with differences in clinical outcome.

Hodgkin’s Disease: Clinical Presentation and Treatment

2001 ◽  
pp. 247-265 ◽  
Author(s):  
Umberto Tirelli ◽  
Emanuela Vaccher ◽  
Michele Spina ◽  
Antonino Carbone
Keyword(s):  
Hodgkin's Disease ◽  
Clinical Presentation ◽  
Hodgkin’S Disease

Management of localized, infradiaphragmatic Hodgkin’s disease: Experience of a rare clinical presentation at St. Bartholomew’s Hospital

1985 ◽  
pp. 393-401
Author(s):  
M. S. Dorreen ◽  
P. F. M. Wrigley ◽  
A. E. Jones ◽  
W. S. Shand ◽  
A. G. Stansfeld ◽  
...  
Keyword(s):  
Hodgkin's Disease ◽  
Clinical Presentation ◽  
Hodgkin’S Disease ◽  
Disease Experience

Cavernous sinus syndrome caused by a primary paranasal sinus non-Hodgkin's lymphoma

1998 ◽  
Vol 112 (8) ◽  
pp. 777-778 ◽  
Author(s):  
Ziv Williams ◽  
Alex Norbash ◽  
Richard L. Goode
Keyword(s):  
Cavernous Sinus ◽  
Paranasal Sinuses ◽  
Hodgkin’S Lymphoma ◽  
Signs And Symptoms ◽  
Hodgkin's Lymphoma ◽  
Nerve Paralysis ◽  
Cavernous Sinus Syndrome ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Hodgkin's Lymphomas

AbstractAlthough uncommon, non-Hodgkin's lymphomas occasionally arise from the nose and paranasal sinuses. Rarely, they may invade into the cavernous sinus and produce signs and symptoms that characteristically include unilateral ophthalmoplegia, sensation loss in the distribution of the ophthalmic and other divisions of the trigeminal nerve, sympathetic nerve paralysis and proptosis. In this report, we present a case of cavernous sinus syndrome (CSS) caused by infiltration of non-Hodgkin's lymphoma from the adjacent paranasal sinuses and address issues regarding its diagnosis and treatment.

Sign in / Sign up

Export Citation Format

Share Document