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Wei M, Jiang W, Wang R, Xiao B, Zhan Q. Langerhans cell histiocytosis of the skull in 23 children. Eur J Med Res 2024; 29:136. [PMID: 38368348 PMCID: PMC10874530 DOI: 10.1186/s40001-024-01727-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 02/12/2024] [Indexed: 02/19/2024] Open
Abstract
OBJECTIVE To explore the clinical features, diagnosis, treatment and prognosis of Langerhans cell histiocytosis (LCH) of the skull in children. METHODS This study retrospectively summarized the clinical manifestations, treatment methods and follow-up status of children with skull LCH who were admitted to the Department of Neurosurgery of Shanghai Children's Hospital from January 2014 to June 2021. RESULTS A total of 23 patients confirmed by histology as LCH received hospitalization treatment, including 14 males and 9 females, aged (5.76 ± 3.86) years old. The clinical manifestations were mostly incidentally discovered head masses that gradually enlarged (19 cases, 82.61%). Only 2 cases are affected by multiple systems, while the rest are affected by single systems. 9 patients were involved in multiple skull lesions, and 14 patients had local skull lesions. All patients underwent surgical intervention, with 17 patients undergoing total resection and 6 patients undergoing biopsy. 21 patients received chemotherapy after surgery. The median follow-up was 2.46 years (range 0.33-6.83 years). 21 patients had their symptoms and signs under control or even resolved, and 2 patients experienced recurrence during follow-up. The overall control rate reached 91.30%. CONCLUSION Personalized treatment plans according to different clinical types. Regular outpatient follow-up is crucial to monitor disease recurrence and late effects.
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Affiliation(s)
- Min Wei
- Department of Neurosurgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Luding Rd. 355, Shanghai, People's Republic of China
| | - Wenbin Jiang
- Department of Neurosurgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Luding Rd. 355, Shanghai, People's Republic of China
| | - Rui Wang
- Department of Neurosurgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Luding Rd. 355, Shanghai, People's Republic of China
| | - Bo Xiao
- Department of Neurosurgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Luding Rd. 355, Shanghai, People's Republic of China
| | - Qijia Zhan
- Department of Neurosurgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Luding Rd. 355, Shanghai, People's Republic of China.
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Padmanaban K, Kamalakaran A, Raghavan P, Palani T, Rajiah D. Langerhans Cell Histiocytosis of the Mandible. Cureus 2022; 14:e28222. [PMID: 36158441 PMCID: PMC9486456 DOI: 10.7759/cureus.28222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2022] [Indexed: 11/05/2022] Open
Abstract
The unusual disorder known as Langerhans cell histiocytosis, which is most frequently seen in children and young adults, is caused by the clonal proliferation of Langerhans cells. Even if clinical signs and radiographic evidence of destructive bone lesions may raise suspicion of the disease, a reliable diagnosis without a thorough pathological examination is challenging. This report describes a case of eosinophilic granuloma of the mandible in a nine-year-old child with characteristic radiological, histopathological, and immunohistochemical features.
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Mishra A, Gyawali S, Kharel S, Mishra A, Kuikel S, Pathak N, Gurung A. Incidental finding of Langerhans cell histiocytosis of temporoparietal bone - A case report. Int J Surg Case Rep 2021; 85:106179. [PMID: 34274753 PMCID: PMC8319439 DOI: 10.1016/j.ijscr.2021.106179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/02/2021] [Accepted: 07/06/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction and importance Langerhans cell histiocytosis (LCH) is a rare haematological disorder affecting infants and young children and has an estimated incidence of 2-5 cases per million people per year. LCH invades the reticuloendothelial system and causes the proliferation of Langerhans cells and mature eosinophils. LCH involving the temporoparietal bone has rarely been reported in the literature. Presentation of case A ten-year-old boy presented to the Neurosurgical outpatient clinic with a swelling on the right temporoparietal region following a fall from his bicycle. Local examination revealed a single, 3 × 3 cm, non-tender, cystic, immobile swelling in the right temporoparietal region. On evaluation for recent head trauma, an incidental finding of eosinophilic granuloma was discovered on a CT scan. The FNAC was suggestive of a histiocytic lesion pertaining to a diagnosis of LCH. The patient underwent wide excision of the mass and cranioplasty. A one-month follow-up CT scan of the head had no evidence of residual or recurrent disease. Discussion Eosinophilic granuloma is one of the three variants of LCH and has a relatively better prognosis. Clinical diagnosis can be challenging and mandates tissue sampling for histopathological examination. Treatment modalities including surgery, radiotherapy, chemotherapy, and steroid injection are used alone, or in combination, depending on the extent and severity of the disease. Conclusion Examining a swelling in the temporoparietal region with no other characteristic symptoms could be a case of LCH. The timely diagnosis and surgical excision with other adjuvant treatment options of this rare pediatric disease would help in a better outcome. Langerhans cell histiocytosis can present as a mass in the temporal or parietal region with no symptoms otherwise. The etiology of Langerhans cell histiocytosis is still unknown and diagnosis can be challenging. The prognosis depends greatly on early identification and prompt surgical treatment.
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Affiliation(s)
- Aakash Mishra
- Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal.
| | - Sandesh Gyawali
- Department of General Surgery, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - Sanjeev Kharel
- Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu, Nepal.
| | - Aman Mishra
- Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu, Nepal.
| | - Sandip Kuikel
- Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu, Nepal.
| | - Nibesh Pathak
- Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu, Nepal.
| | - Ashim Gurung
- Department of Neurosurgery, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal
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Sahu B, Anand R, Kumar S, Solanki RS, Mehra P, Jain M. A Pattern-based Imaging Approach to Pediatric Jaw Lesions. Indian J Radiol Imaging 2021; 31:210-223. [PMID: 34316129 PMCID: PMC8299508 DOI: 10.1055/s-0041-1729767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Jaw lesions in the pediatric population, although infrequently encountered in clinical practice, can cause functional impairment and cosmetic disfiguring. It is further complicated by the difficulty in diagnosis due to complex anatomy and facial developmental process during infancy and childhood. Intraosseous pediatric jaw lesions may vary from odontogenic to nonodontogenic types with nonspecific clinical features in most cases. They deserve careful attention by a systematic approach to provide a relevant diagnosis or differential diagnosis for timely management. Imaging plays a major role in diagnosis with orthopantomograph being the foremost investigation, followed by cross-sectional imaging, essentially computed tomography as a problem-solving tool. This article highlights the imaging spectrum of various jaw lesions in the pediatric population with a pattern-based approach for radiological diagnosis.
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Affiliation(s)
- Biswanath Sahu
- Department of Radio-Diagnosis, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Rama Anand
- Department of Radio-Diagnosis, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Sandeep Kumar
- Department of Radio-Diagnosis, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Ravi Shankar Solanki
- Department of Radio-Diagnosis, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Pravesh Mehra
- Department of Dental and Oral Surgery, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Manjula Jain
- Department of Pathology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
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LIEVERSE ANGELAR, KUBO DAISUKE, BOURGEOIS REBECCAL, MATSUMURA HIROFUMI, YONEDA MINORU, ISHIDA HAJIME. Pediatric mandibular osteomyelitis: a probable case from Okhotsk period (5th–13th century AD) northern Japan. ANTHROPOL SCI 2021. [DOI: 10.1537/ase.2108281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
| | - DAISUKE KUBO
- Faculty of Medicine, Hokkaido University, Sapporo
| | | | | | | | - HAJIME ISHIDA
- Human Biology and Anatomy, Graduate School of Medicine, University of the Ryukyus, Nishihara
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de Camargo Moraes P, Montalli VAM, Tincani AJ, de Mendonça RMH, Alvarenga CA, Junqueira JLC, Oliveira LB. Langerhans cell histiocytosis: A case report in a 2-year old child. PEDIATRIC DENTAL JOURNAL 2019. [DOI: 10.1016/j.pdj.2019.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Rao S, Hegde S, Thilak PSG, Babu GS, Ajila V, Shetty U, Buch SA. Langerhans Cell Histiocytosis in a 5-Year-Old Girl: A Case Report and Review of Literature. Indian J Med Paediatr Oncol 2019. [DOI: 10.4103/ijmpo.ijmpo_258_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AbstractLangerhans cell histiocytosis (LCH) is an uncommon hematological disorder affecting infants and young children. LCH is a rare disorder of the reticuloendothelial system associated with proliferation of Langerhans cells and mature eosinophils. LCH can involve any bone, but the most common are pelvis, ribs, skull, long bones, vertebra, and facial bones. In the skull, frontal and parietal bones are commonly involved followed by the jaws, where mandible is more commonly affected than the maxilla. In this article, we report a case of LCH in a 5-year-old child involving the mandible. Swelling of one side of the face and aggressive periosteal reaction led to the diagnosis of monostotic LCH. The manuscript also summarizes the results of a literature search in PubMed of reported cases of LCH over the past 10 years.
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Affiliation(s)
- Shruthi Rao
- Consultant, General Dental Practitioner, Mangala Health Centre, Padil, Karnataka, India
| | - Shruthi Hegde
- Departments of Oral Medicine and Radiology, A B Shetty Memorial Institute of Dental Sciences, Nitte Deemed to be University, Karnataka, India
| | - PS Gopinath Thilak
- Departments of Oral and Maxillofacial Surgery and Oral Pathology and Microbiology, A B Shetty Memorial Institute of Dental Sciences, Nitte Deemed to be University, Karnataka, India
| | - G Subhas Babu
- Departments of Oral Medicine and Radiology, A B Shetty Memorial Institute of Dental Sciences, Nitte Deemed to be University, Karnataka, India
| | - Vidya Ajila
- Departments of Oral Medicine and Radiology, A B Shetty Memorial Institute of Dental Sciences, Nitte Deemed to be University, Karnataka, India
| | - Urvashi Shetty
- Departments of Oral Pathology and Microbiology, A B Shetty Memorial Institute of Dental Sciences, Nitte Deemed to be University, Karnataka, India
| | - Sajad Ahmad Buch
- Departments of Research Scholar, Yenepoya Dental College, Yenopoya (Deemed to be) University, Mangaluru, Karnataka, India
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Abstract
Most pathologic lesions of the jaws or of oral mucosa are treated successfully by surgical interventions. For treatment of the central giant cell lesion, aneurysmal bone cysts, histiocytosis of the mandible, hemangioma, odontogenic keratocyst, Paget disease, oral submucous fibrosis, and oral lichen planus, medical management consisting of intralesional injections, sclerosing agents, and systemic bisphosphonates is as successful as surgical procedures with fewer complications. Pharmacology of agents used and protocols are presented.
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Affiliation(s)
- Orrett E Ogle
- Mona Dental Program, Faculty of Medical Sciences, University of the West Indies, Kingston, Jamaica; Oral and Maxillofacial Surgery, Woodhull Medical Center, Brooklyn, NY, USA.
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Kadlub N, Kreindel T, Belle Mbou V, Coudert A, Ansari E, Descroix V, Ruhin-Poncet B, Coulomb L'Hermine A, Berdal A, Vazquez MP, Ducou Lepointe H, Picard A. Specificity of paediatric jawbone lesions: Tumours and pseudotumours. J Craniomaxillofac Surg 2014; 42:125-31. [DOI: 10.1016/j.jcms.2013.03.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 03/20/2013] [Accepted: 03/21/2013] [Indexed: 12/12/2022] Open
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Dental Anatomy and Pathology Encountered on Routine CT of the Head and Neck. AJR Am J Roentgenol 2013; 201:W843-53. [DOI: 10.2214/ajr.12.9616] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Krasteva A, Obreshkova E, Michaylova H, Aleksiev E, Kisselova A, Krastev Z. Oral Cavity and Systemic Diseases—Langerhans Cell Histiocytosis. BIOTECHNOL BIOTEC EQ 2012. [DOI: 10.5504/bbeq.2012.0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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