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Xiang Y, He S, Zhou Z, Gan Q, Jin K. Cranial fasciitis in children: clinicoradiology features and management. BMC Pediatr 2022; 22:551. [PMID: 36114476 PMCID: PMC9482288 DOI: 10.1186/s12887-022-03610-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 09/14/2022] [Indexed: 12/03/2022] Open
Abstract
Background Cranial fasciitis (CF) is a rare benign fibroproliferative lesion of the skull. To date, the summarized radiologic characteristics and the subtype of the disease have not been reported. our purpose was to summarize the characteristic clinicoradiology features and management of CF and to improve the knowledge of radiologists and clinicians. Methods We searched our institution’s database and retrieved the clinical and radiologic data of CF patients confirmed by histopathological examination. The clinicoradiology features and management of CF were analysed retrospectively. Results A total of 14 CF patients were included. A total of 85.7% of the patients presented with a painless, firm, nonmobile and single mass. Tenderness and multiple masses were found in 14.3% of the patients. The mass was clearly increased in 2 patients and gradually increased in 5 patients in the short term. We divided these patients into three types based on the CT characteristics. The characteristic features of type I (9 patients) presented as an expansive and osteolytic bone destruction with a soft tissue mass. Type II (2 patients) presented as a scalp mass with mild erosion of the outer skull plate. Type III (3 patients) presented as a scalp mass without skull destruction. All patients underwent surgical resection. For type I patients, craniectomy and cranioplasty were performed. For type II patients, complete excision of the scalp mass with local skull curettage was performed. For type III patients, complete excision of the scalp mass was performed. There were no cases of recurrence after follow-up. Conclusions CF usually presents as a painless, firm, nonmobile and single mass with a clear boundary. There are generally three types of MSCT findings: bone destruction with a soft tissue mass, a scalp mass with erosion of the skull and a scalp mass. Different management strategies should be utilized for the various types of CF.
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Granata F, Morabito R, Grasso G, Alafaci E, Salpietro FM, Alafaci C. A rare case of solitary brain Langerhans cell histiocytosis with intratumoral hemorrhage in a patient affected by Turner syndrome. Surg Neurol Int 2016; 7:31. [PMID: 27127696 PMCID: PMC4828955 DOI: 10.4103/2152-7806.179429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 02/29/2016] [Indexed: 12/14/2022] Open
Abstract
Background: Langerhans cell histiocytosis (LCH) is a rare disease involving clonal proliferation of cells with characteristics similar to bone marrow-derived Langerhans cells. The case of a young woman, affected by Turner syndrome and a solitary intraparenchymal LCH associated with an osteolytic lesion of the overlying skull, is presented. Case Description: The patient, with an insidious history of headache and a growing soft mass in the left frontal region, presented with a sudden generalized tonic-clonic epileptic seizure. Neuroradiological investigations showed an osteolytic lesion of the left frontal bone and an underlying brain lesion associated with recent signs of bleeding. The patient was operated on with a complete removal of the lesion. The postoperative course was uneventful. Conclusions: The clinical, neuroradiological, and intraoperative findings are presented, along with a review of the literature. Although rare, LCH should be considered in the differential diagnosis when a scalp lesion occurs with a progressive growing.
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Affiliation(s)
- Francesca Granata
- Department of Radiological Sciences, University of Messina, Messina, Italy
| | - Rosa Morabito
- Department of Radiological Sciences, University of Messina, Messina, Italy
| | - Giovanni Grasso
- Department of Experimental Biomedicine and Clinical Neurosciences (BIONEC), University of Palermo, Palermo, Italy
| | - Elisabetta Alafaci
- Department of Human Pathology, Medical Oncology Unit, University of Messina, Messina, Italy
| | | | - Concetta Alafaci
- Department of Neurosurgery, University of Messina, Messina, Italy
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Ramos-Gutiérrez E, Alejo-González F, Ruiz-Rodríguez S, Garrocho-Rangel JA, Pozos-Guillén A. Langerhans cell histiocytosis: Current concepts in dentistry and case report. J Clin Exp Dent 2016; 8:e102-8. [PMID: 26855698 PMCID: PMC4739360 DOI: 10.4317/jced.52498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 08/13/2015] [Indexed: 11/23/2022] Open
Abstract
Langerhans cell histiocytosis (LCH), which is a rare granulomatous pediatric disease of unknown etiology, is characterized by the idiopathic proliferation and accumulation of abnormal and clonal Langerhans cells or their marrow precursors, resulting in localized, solitary or multiple destructive lesions. These lesions are most commonly eosinophilic granuloma, which are found in craniofacial bone structures such as the skull and mandible, skin and other organs. In children, the disease has a variable initial presentation, and the clinical course, prognosis and survival are unpredictable. The aims of this report were to present an LCH case in a girl aged 2 years, 8 months and her clinicopathological features, to describe the bucodental management provided, and to discuss special dental considerations of this disease.
Key words:Children, dental management, histiocytosis, Langerhans cells.
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Affiliation(s)
- Efraín Ramos-Gutiérrez
- DDS, Resident, Pediatric Dentistry Postgraduate Program, Faculty of Dentistry, San Luis Potosi University, SLP, Mexico
| | - Francisco Alejo-González
- MD, MS, Associate Professor, Pediatric Dentistry Postgraduate Program, Faculty of Dentistry, San Luis Potosi University, SLP, Mexico
| | - Socorro Ruiz-Rodríguez
- DDS, MS, Chairman, Pediatric Dentistry Postgraduate Program, Faculty of Dentistry, San Luis Potosi University, SLP, Mexico
| | - José-Arturo Garrocho-Rangel
- DDS, MS, PhD, Associate Professor, Pediatric Dentistry Postgraduate Program, Faculty of Dentistry, San Luis Potosi University, SLP, Mexico
| | - Amaury Pozos-Guillén
- DDS, MS, PhD, Associate Professor, Pediatric Dentistry Postgraduate Program, Faculty of Dentistry, San Luis Potosi University, SLP, Mexico
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Bezdjian A, Alarfaj AA, Varma N, Daniel SJ. Isolated Langerhans Cell Histiocytosis Bone Lesion in Pediatric Patients: Systematic Review and Treatment Algorithm. Otolaryngol Head Neck Surg 2015; 153:751-7. [PMID: 26243026 DOI: 10.1177/0194599815598969] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 07/14/2015] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The present study reviewed all cases reported of isolated Langerhans cell histiocytosis bone lesions in the head and neck of pediatric patients. The objective was to create a treatment algorithm to facilitate the diagnosis and management of these lesions. DATA SOURCES Eligible articles were identified through a comprehensive search of the following electronic databases: PubMed, Ovid Medline, Embase, and Cochrane Library. REVIEW METHODS Two authors independently reviewed the titles and abstracts retrieved by the electronic search concordant with the criteria for study eligibility. The lists of articles from each author were jointly reviewed and a common list created. All relevant articles were reviewed in hard copies and as full texts to justify inclusion. RESULTS A total of 201 patients (67% male, mean age: 8.1 ± 4.3 years) were included from 45 studies. Clinical presentations included swelling (64%), pain (9%), or both (18%). The skull (61%) and the orbit (24%) were the most common location for isolated bone lesions in the head and neck. The most frequently documented management option was resection, followed by observation, chemotherapy, and intralesional steroid injection. CONCLUSIONS Due to its rarity and variability in presentation and severity, treatment of these lesions has yet to be standardized. Based on the review, a diagnosis and treatment algorithm was created for head and neck surgeons when encountering these types of lesions.
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Affiliation(s)
- Aren Bezdjian
- Department of Otolaryngology-Head and Neck Surgery, The Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada
| | - Abdullah A Alarfaj
- Department of Otolaryngology-Head and Neck Surgery, The Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada
| | - Namrata Varma
- Department of Otolaryngology-Head and Neck Surgery, The Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada
| | - Sam J Daniel
- Department of Otolaryngology-Head and Neck Surgery, The Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada
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Xie SM, Liu W, Xiang YY, Xiao ZA, Ren HM, Peng AQ, Wu WJ, Yang XM, Xie DH, Yin TF, Ren JH. A rare disorder mimics otitis media: Langerhans cell histiocytosis of the temporal bone in a child with interstitial pulmonary fibrosis. Am J Otolaryngol 2014; 35:816-21. [PMID: 25139821 DOI: 10.1016/j.amjoto.2014.06.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Revised: 06/25/2014] [Accepted: 06/30/2014] [Indexed: 11/28/2022]
Abstract
Langerhans cell histiocytosis (LCH) is a rare disease ranging from a benign to a rapidly fatal condition affecting young children predominantly, and is characterized by an abnormal clonal proliferation of Langerhans cells. We report a case of a 3-year-old child presenting with a 1-year history of otorrhea and otorrhagia followed by a 6-month history of postauricular swelling in the right ear. Imaging demonstrated a large mass of organized tissue. A biopsy was conducted, and the diagnosis of LCH was confirmed by histopathological and immunohistochemical examination. The child was treated with a 12-month course of vinblastine chemotherapy with prednisolone. No clinical evidence of recurrence was noticed after 3 years of follow-up. This rare case highlights the importance for otolaryngologists to keep LCH in mind for differential diagnosis in very young patients with symptoms and signs suggestive of acute mastoiditis or chronic otitis media.
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Affiliation(s)
- S M Xie
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital of Central South University, Changsha, PR China
| | - W Liu
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital of Central South University, Changsha, PR China
| | - Y Y Xiang
- Department of Human Anatomy, University of South China, Hengyang, PR China
| | - Z A Xiao
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital of Central South University, Changsha, PR China
| | - H M Ren
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital of Central South University, Changsha, PR China
| | - A Q Peng
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital of Central South University, Changsha, PR China
| | - W J Wu
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital of Central South University, Changsha, PR China
| | - X M Yang
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital of Central South University, Changsha, PR China
| | - D H Xie
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital of Central South University, Changsha, PR China
| | - T F Yin
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital of Central South University, Changsha, PR China
| | - J H Ren
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital of Central South University, Changsha, PR China.
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Shi S, Liu Y, Fu T, Li X, Zhao S. Multifocal Langerhans cell histiocytosis in an adult with a pathological fracture of the mandible and spontaneous malunion: A case report. Oncol Lett 2014; 8:1075-1079. [PMID: 25120660 PMCID: PMC4114718 DOI: 10.3892/ol.2014.2272] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 05/23/2014] [Indexed: 11/22/2022] Open
Abstract
Langerhans cell histiocytosis (LCH) is rare in the adult population and even rarer with jaw involvement. The current study presents the case of a 39-year-old male who complained of recurrent pain, swelling of the gingiva and an occasional pus-like discharge in the right mandible for one year. The patient was previously prescribed antibiotics, but this did not resolve the problem. An initial panoramic radiograph showed an osteolytic lesion and bone fracture in the right mandible. Eight months later, a new radiograph showed the spontaneous malunion of the fractured mandible. The patient was eventually diagnosed with Langerhans cell histiocytosis by histopathology and immunohistochemistry. Further lesions were found in the ribs and ilium by nuclear bone scanning. The patient was subsequently treated with systemic chemotherapy, and the lesions are currently effectively being controlled. This study is the first to show that spontaneous intralesional bone regeneration may lead to reunification of the mandible fracture caused by LCH in an adult.
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Affiliation(s)
- Sailang Shi
- Dental Clinic, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
| | - Yanming Liu
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Tao Fu
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Xiuzhen Li
- Department of Pathology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Shifang Zhao
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China ; School of Dentistry, Zhejiang University, Hangzhou, Zhejiang 310006, P.R. China
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Abstract
Eosinophilic granuloma is a type of histiocytosis X that is a benign bone tumor. Multifocal extradural and intradural involvement in adults is extremely uncommon because 90% of cases occur in boys younger than 10 years. The etiology of this disease is unknown, but it occurs with the accumulation of eosinophils and histiocytes in the medullary layers of the bone. The beginning of the inflammatory process in the dural membrane after migration of Langerhans cells may result in intradural involvement and sinus invasion into the nearby tissue. For multiple bone lesions, the use of chemotherapy, radiotherapy, and systematic cortisone is effective. In this study, we discuss the case of a 44-year-old man with sinus compression and multiple painful cranial swellings who was admitted to our clinic.
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Treatment options for localized Langerhans cell histiocytosis. ACTA ACUST UNITED AC 2010; 109:801-2. [DOI: 10.1016/j.tripleo.2010.02.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Revised: 02/11/2010] [Accepted: 02/16/2010] [Indexed: 12/29/2022]
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