Reply
Dr. Singher's comments about our case report concentrate on the conservative treatment of children's leukemia that has greatly increased the survival of these patients during the last few years. At the time when our patient with lymphosarcoma came to treatment in the pediatric department over three years ago, present therapeutic concepts of CNS treatment were not employed with today's frequency, and the patient was treated with chemotherapy combined with local irradiation. However, four weeks after the initiation of treatment metastatic nodules were found in the abdominal scar, tumor masses were palpated in the pelvis, and the patient deteriorated rapidly despite the continuation of the treatment, dying about four months after the beginning of treatment.
Considering the facial paralysis, its occurrence in the case of lymphosarcoma is, without a doubt, an evidence of CNS spread of this disease. The adjunct of intrathecal methotrexate and cranial irradiation1 is surely of value