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September 26, 1977

Undifferentiated Sarcoma: Arising in Previous Hodgkin's Radiation Field

JAMA. 1977;238(13):1396-1397. doi:10.1001/jama.1977.03280140074027

SARCOMAS of the chest wall appearing after postoperative radiation therapy for breast carcinoma have recently been reviewed by Travis et al.1 Less well documented are instances of such tumors developing in persons receiving nodal and mediastinal irradiation for Hodgkin's disease. We report such an occurrence.

Report of a Case  A 42-year-old woman, in 1969, had a history of fever, pruritis, and enlarged cervical lymph nodes, which were diagnosed by node biopsy as having nodular sclerosing Hodgkin's disease. Chest roentgenograms demonstrated a widened mediastinum and a large mediastinal mass consistent with Hodgkin's involvement. A lymphangiogram showed right periaortic nodes to be abnormal. Between March 11 and April 4, 1969, the patient was treated with a cobaltous chloride Co 60 mantle and received 3,550 R at the sternal notch, and 3,340 R at the xiphoid process. During this initial therapy, her systemic symptoms cleared and the mediastinal mass regressed to the