The authors report the case of a boy, 9 years old, with a mass in the sternum and the anterior region of the mediastinum. A biopsy of the sternal mass was performed and demonstrated a Hodgkin disease variety nodular sclerosis. The disease was classified as stage III A after that two lymph nodes on the right side of the groin were revealed by lymphography. Therapy consisted of 6 alternate MOPP/ABVD cycles, followed by mantle and inverted Y field radiotherapy for a total of 25 Cg and 5 Cg booster on a sternum. During chemotherapy there was a complete regression of the disease in all sites. At present the patient is healthy and in complete remission and "off therapy", with a follow-up of 32 months. The most interesting aspect of this case is the sternum involvement as the initial manifestation of the nodular sclerosing form of Hodgkin's disease.