Hodgkin lymphoma patient presenting as superior vena cava syndrome in a patient suffering from myotonia congenita: A rare case scenario

Abstract

A 14-year-old male who was a known case of myotonia congenital (MC) (SCN4A mutation related) on Tab phenytoin therapy presented with progressive shortness of breath, swelling of face, and intermittent fever for 2 months. On investigation, a middle mediastinal mass was diagnosed and histopathological examination along with immunohistochemistry revealed it to be Hodgkin lymphoma (HL). The patient was started on Inj. dexamethasone for superior vena cava syndrome followed by doxorubicin, vincristine, etoposide, and prednisolone chemotherapy and phenytoin dose adjustment. The patient responded well to treatment. This case summarizes the management in patients of HL presenting as superior vena cava syndrome in a background of MC on enzyme inducer therapy.