[Glioblastoma multiforme in a patient with a second complete remission of Hodgkin's disease]

Treatment of Hodgkin's disease contributes to the appearance of second malignant neoplasias such as glioblastoma multiforme. Amongst the known etiological hypotheses is alteration of the immune system secondary to chemotherapy. We seek new hypotheses relating this rare association. With better understanding of the causes provoking the appearance of these tumors new strategies could be designed for treatment.

A 26 year old man who was in a second complete remission of a nodular sclerosis type of Hodgkin's disease complained of headache and evening fever. Magnetic resonance showed a right frontal 6 x 5 x 4 cm cystic lesion with a vascular solid zone, with irregular margins and surrounded by vasogenic oedema. On investigation there were reduced levels of immunoglobulins G (522 mg/dl)) and M (38 mg/dl). The lesion was removed surgically and histological studies confirmed the diagnosis of glioblastoma multiforme.

Although immunosuppression may contribute to the appearance of secondary neoplasia, it is not the only hypothesis in the case of glioblastoma multiforme occurring in a patient with Hodgkin's disease. In the literature similar cases, both isolated and familial, have been reported and may have been affected by genetic or environmental factors which are as yet unknown.