Management of Anterior Mediastinal Hodgkin’s Lymphoma in Polycystic Kidney Disease: A Case Report

TL;DR

A 33-year-old man with kidney disease and Hodgkin’s lymphoma received chemotherapy while managing his kidney function, eventually requiring a kidney transplant.

Contribution

This case highlights treatment strategies for Hodgkin’s lymphoma in patients with pre-existing kidney disease.

Findings

Hodgkin’s lymphoma was successfully treated in a patient with polycystic kidney disease.

Chemotherapy required modifications due to declining kidney function.

Renal transplant was eventually needed after continued kidney function decline.

Abstract

This case report presents a 33-year-old male with polycystic kidney disease (PKD) who presented with superior vena cava syndrome due to an anterior mediastinal mass. Imaging and pathology confirmed a Hodgkin’s lymphoma of nodular sclerosis subtype of the mediastinum. Despite chronic kidney disease, prioritization to treat the Hodgkin’s lymphoma was taken with careful monitoring of renal function. Renal function declined throughout chemotherapy, necessitating modification to the chemotherapy regimen, but not requiring dialysis. Three years following remission from lymphoma, renal function continued to decline, prompting renal transplant and bilateral nephrectomy. This case highlights considerations in treatment for oncological disease with pre-existing decreased kidney function.

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