Hodgkin's disease associated with neurologic paraneoplastic syndrome.

In this case of neurologic paraneoplastic syndrome in a patient with Hodgkin's disease, both the Hodgkin's disease and the associated neurologic syndrome were cured by surgical intervention and postoperative adjuvant chemotherapy. The patient's tumor was removed en bloc. Postoperative chemotherapy consisted of doxorubicin (Adriamycin), etoposide, and vinblastine. At 5-year follow-up in August 1996, the patient was active and tumor-free, without evidence of recurrent Hodgkin's disease or paraneoplastic syndrome. The possibility that this patient's syndrome was the result of a cross-reacting monoclonal idiotype produced by his tumor is suggested by the rapid recovery associated with tumor debulking. The role of surgery in the treatment of patients with Hodgkin's disease is limited, well defined, and even more infrequent in recurrent disease. Systemic chemotherapy is the treatment of choice for these patients, but surgery may play an important role in the initial cytoreduction of the recurrent tumor, especially in cases of localized bulky disease.