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To the Editor.
—Though the article by Durkin and Durant in the March Archives (139:333-336,1979) may be a worthwhile contribution to the internal medicine literature, their observation concerning residual mass lesions following treatment for Hodgkin's disease is by no means an original realization. Most radiotherapists with substantial experience in the treatment of Hodgkin's disease have learned to anticipate that it is not unusual for a patient to have persistent fibrotic masses in a region of previous massive tumor involvement. As with the two cases reported by Durkin and Durant, this is most usually seen with the nodular sclerosing variety. In view of the relative frequency with which this phenomenon occurs, I would certainly be very skeptical of a recommendation of thoracotomy for a patient with a persistent mediastinal mass four months following mantle irradiation.For a concise and straightforward description of the phenomenon of persistent benign mass lesions following treatment
Gibbs FA. Hodgkin's Disease. Arch Intern Med. 1980;140(2):284. doi:10.1001/archinte.1980.00330140142048