[Thoracic tumors after treatment for Hodgkin disease]

Twenty-one patients were admitted to the surgical unit for management of an intra-thoracic mass following treatment of Hodgkin's disease (HD). They consisted of 14 males and 7 females, with a mean age of 34 years (range: 17-62). Seven had recurrent HD, 14 had a non-Hodgkin solid tumour. HD recurrences were treated with repeated chemotherapy with 4 prolonged survivals including 1 relapse (40 to 84 months follow-up). Non-Hodgkin tumours were 13 lung carcinomas, which were resected in 4 cases, with only 1 prolonged survival (54 months) and malignant schwannoma. HD recurrences are observed equally in both young males and females and are subsequent to a mediastinal location of the disease, after an average 3.2 years. They are located on the borders or irradiation fields. Repeated chemotherapy is effective. Carcinomas more often appear in males, at an older age, in a favorable clinical context, after an average 10.2 years. Their prognosis is very poor. Irradiation and chemotherapy contribute to their development. Long-term risks of HD treatment must be considered.