Abstract
A 16-year-old female visited our hospital because of a mass on the neck. On physical examination, masses were palpated in the left supraclavicular fossa and on the left anterior chest wall. Biopsy studies provided no definitive diagnosis, and exploratory operation was carried out. The masses on the chest wall and in the supraclavicular fossa could be resected, but a third mass in the thymus was tightly adhered to the pericardium and could only be partially resected. Pathologic examination of the resected specimens indicated Hodgkin's disease, nodular sclerosis. The patient has been managed postoperatively by alternating COPA-ABVD therapy.
Although Hodgkin's disease can be successfully treated by chemotherapy and radiation therapy, the frequency of local recurrence is considered to be high in cases with very large masses in the mediastinum even after combination chemotherapy and radiation therapy. In adition the diagnosis of Hodgkin's disease, nodular sclerosis is often difficult. For these reasons, surgical resection is considered to be important both for the diagnostic purpose and as a part of the adjuvant therapy in anterior mediastinal tumors showing chest wall infiltration.
