A case of biopsy-proven thymic hyperplasia is described in a child with group I paratesticular rhabdosarcoma while on chemotherapy. Other cases of children with cancer reported with this phenomenon are reviewed. Tissue diagnosis is important to differentiate metastatic tumor and to rule out second malignancies in these patients. The initial evaluations are facilitated by CT scanning of the chest and upper extremity venography.

A patient is described who developed Hodgkin's disease 16 years after treatment of Wilms' tumor with radiation and actinomycin D. The issues relating to Hodgkin's disease as a second malignancy are reviewed. The need for long-term surveillance of patients with malignant disease for late effects of the cancer and its treatment is emphasized.

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