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Chen T, Ashman PE, Bojrab DI, Johnson AP, Benson B, Hong RS, Svider PF. Otologic Manifestations of Langerhans Cell Histiocytosis: A Systematic Review. Otolaryngol Head Neck Surg 2021; 166:48-59. [PMID: 33945752 DOI: 10.1177/01945998211004590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To perform a systematic review to investigate common otologic manifestations of Langerhans cell histiocytosis, the incidence of these findings, methods for diagnosis, as well as medical and surgical management. DATA SOURCES PubMed/MEDLINE, Embase, and Cochrane Library. REVIEW METHODS A search of PubMed/MEDLINE, Embase, and Cochrane Library for all articles published between 1963 to 2020 was performed with variations and combinations of the following search terms: Langerhans cell histiocytosis, eosinophilic granuloma, Letterer-Siwe, Hand-Schüller-Christian, otitis, otologic, ear. A review of the references of all included articles was also conducted. RESULTS Sixty-two articles encompassing 631 patients met inclusion criteria. Otologic symptoms at presentation were found in 246 (39%) patients in the reported studies with 48% reporting bilaterality. The mean age was 14.8 years with a male predominance (64%). The most common otologic presenting symptom was otorrhea (46%). A majority had the multisystem variant (52%). The most common treatment modalities were chemotherapy (52%), followed by surgery (50%), systemic steroids (45%), and radiotherapy (31%). Surgery was performed in 75.8% with unisystem involvement and in 50.6% with multisystem involvement. The most effective treatments included radiotherapy (56% success rate, 17% of treated patients), systemic steroids (44% success, 20% treated), chemotherapy (41% success, 21% treated), and surgical modalities (36% success, 19% treated). CONCLUSIONS Otologic manifestations that occur with the multisystem variant or are at high risk for central nervous system involvement necessitate systemic treatment. For unifocal lesions, surgery is recommended. Lastly, radiotherapy should be reserved for extensive lesions involving vital structures or presenting in older patients.
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Affiliation(s)
- Tiffany Chen
- Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | - Peter E Ashman
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | | | - Andrew P Johnson
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, Colorado, USA
| | - Brian Benson
- Hackensack Meridian School of Medicine, Nutley, New Jersey, USA.,Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Robert S Hong
- Michigan Ear Institute, Farmington Hills, Michigan, USA.,Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Wayne State University, Detroit, Michigan, USA
| | - Peter F Svider
- Hackensack University Medical Center, Hackensack, New Jersey, USA.,Bergen Medical Associates, Emerson, New Jersey, USA
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Reisi N, Raeissi P, Harati Khalilabad T, Moafi A. Unusual sites of bone involvement in Langerhans cell histiocytosis: a systematic review of the literature. Orphanet J Rare Dis 2021; 16:1. [PMID: 33388073 PMCID: PMC7778820 DOI: 10.1186/s13023-020-01625-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 11/26/2020] [Indexed: 12/14/2022] Open
Abstract
Background Langerhans cell histiocytosis (LCH) is a rare disease that originates from the uncontrolled proliferation and accumulation of bone marrow-derived immature myeloid dendritic cells. Dendritic cells are a type of histiocyte that play an important role in the human immune system and are found in the bone, skin, stomach, eyes, intestines, and lungs.
Objective This systematic review aimed to collect and report published case reports of rare bone disease caused by LCH to avoid misdiagnoses or delays in diagnosis. Methods We systematically searched Scopus, PubMed, Embase, and Web of Sciences from August 1, 2000 to December 31, 2019. Studies reporting cases of LCH with rare bone involvement were included. Results We identified 60 articles including 64 cases. Of the identified cases, 31 (48.4%) involved children, and 33 (51.6%) involved adults. Additionally, 46.9% (30 individuals) were from Asian countries. The mean age of the children was 7.6 ± 4.3 years and that of the adults was 36 ± 12 years. The findings indicated that unifocal bone involvements were the most prevalent form of the disease (68.7%), and, overall, the skull and chest wall were the most commonly affected bones in both adults and children. The spine and long bones were the second most commonly affected bones in children, and the spine and jaw were the second most commonly affected bones in adults. Pain and swelling were the most frequent presenting signs among the investigated cases, and loss of consciousness, myelopathy, nerve palsy, visual loss, torticollis and clicking sounds were rare signs. Osteolytic lesions were the most frequent radiologic feature (62.5%), and intracranial hemorrhage, fluid–fluid level, dura and intracranial extension and pathologic fractures were rare radiological features. Total excision, curettage and observation in the unifocal group of patients and systemic chemotherapy in the other groups (i.e., multifocal and multisystem) were the most frequent management approaches. The recovery rates of the unifocal and multifocal groups were 77.3% and 81.8%, respectively, while that of the multisystem group was 55.5%. The rates of recurrence and mortality in the multisystem group were 11% and were higher than those in the other groups. Conclusions LCH is a rare disease that can affect any organ in the human body. However, bone is the most commonly involved organ, and rare bone involvements may be the first or only symptom of the disease due to the rarity of such lesions; a lack of familiarity with them may result in misdiagnosis or delayed diagnosis.
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Affiliation(s)
- Nahid Reisi
- Department of Pediatric Hematology and Oncology, Faculty of Medicine, Child Growth and Development Research Center and Isfahan Immunodeficiency Research Center, Seyed Al-Shohada Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Pouran Raeissi
- Department of Health Services Management, School of Health Management and Medical Information Science, Iran University of Medical Sciences, Tehran, Iran
| | - Touraj Harati Khalilabad
- Department of Health Economics, School of Health Management and Medical Information Science, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Moafi
- Department of Pediatric Hematology and Oncology, Faculty of Medicine, Child Growth and Development Research Center and Isfahan Immunodeficiency Research Center, Seyed Al-Shohada Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
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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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Gupta G, Jain A, Grover M. Successful cochlear implantation in Langerhans cell histiocytosis: A rare case. Cochlear Implants Int 2017; 19:115-118. [PMID: 29157165 DOI: 10.1080/14670100.2017.1402473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
An 8-year-old girl presented with a 1-year history of bilateral progressive hearing loss and vertigo for 6 months. High-resolution computed tomography of the temporal bones demonstrated multiple lytic lesions. Histopathology examination confirmed a diagnosis of Langerhans cell histiocytosis (LCH). She underwent chemotherapy for 12 months. Following treatment, she was in remission. However, the bilateral profound sensorineural hearing loss persisted. She underwent right cochlear implantation with very good functional audiological outcomes. This is the first known reported case of successful auditory rehabilitation through cochlear implantation in a patient with bilateral profound hearing loss due to isolated bilateral temporal bone LCH.
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Affiliation(s)
- Gaurav Gupta
- a Department of Otorhinolaryngology , SP Medical College , Bikaner , Rajasthan , India
| | | | - Mohnish Grover
- c Department of Otorhinolaryngology , SMS Medical College , Jaipur , Rajasthan , India
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Unique Case of Hearing Recovery After Otic Capsule Destruction and Complete Sensorineural Hearing Loss Caused by Langerhans Cell Histiocytosis. Otol Neurotol 2017; 38:1129-1132. [DOI: 10.1097/mao.0000000000001511] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ni M, Yang X. Langerhans' cell histiocytosis of the temporal bone: A case report. Exp Ther Med 2017; 13:1051-1053. [PMID: 28450940 DOI: 10.3892/etm.2017.4072] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 11/10/2016] [Indexed: 12/28/2022] Open
Abstract
Langerhansmporal histiocytosis (LCH) refers to a group of diseases that are characterized by the primary pathogenesis of an abnormal polyclonal proliferation of Langerhans cells that affect different structures of the human body, including the temporal bone. Thus far, the etiology of LCH remains unclear. Diagnosis of LCH is based on a synthetic analysis of the clinical presentations, as well as on features of imaging and histopathology. The clinical features, diagnosis, treatment and prognosis of LCH remain obscure, and temporal LCH is often confused with ear inflammatory lesions and malignant tumors. There are several therapeutic modalities for temporal bone LCH that include surgery, chemotherapy, radiotherapy and steroidal injections. The present study reports the case of an infant presenting a 1-month history of worsening left facial paralysis and a slowly enlarging post auricular mass followed by a 1-month history of postauricular swelling in the left ear. Computed tomography demonstrated a large mass of organized tissue. Moreover, the diagnosis of LCH was confirmed by histopathological and immunohistochemical examinations. The patient also suffered from multiple organ failure, including the liver, kidney, lymphatic system, skin, hematopoietic system and lungs. Following surgical intervention with mastoidotympanectomy, the parents of the patient refused further chemotherapy, and the patient succumbed to the disease ~6 months later.
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Affiliation(s)
- Maomei Ni
- Department of Otorhinolaryngology, Guizhou Provincial People's Hospital, Guiyang, Guizhou 550002, P.R. China
| | - Xiuhai Yang
- Department of Otorhinolaryngology, Guizhou Provincial People's Hospital, Guiyang, Guizhou 550002, P.R. China
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Langerhans Cell Histiocytosis of the Temporal Bone with Otic Capsule Involvement. Clin Neuroradiol 2015; 27:163-168. [PMID: 26341354 DOI: 10.1007/s00062-015-0461-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 08/17/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION This study is conducted to demonstrate that destructive lesions of the otic capsule by Langerhans cell histiocytosis (LCH) causing both radiographic and audiologic findings can be completely reversed with adequate treatment. Retrospective case review and analysis of clinical and imaging data were obtained as part of the diagnosis and treatment of patients with LCH of the temporal bone. METHODS With Institutional Review Board (IRB) approval, cases of LCH involving the temporal bone were searched for within the institutional databases. Criteria for inclusion was histologic diagnosis of LCH and pretreatment computed tomography (CT) demonstrating temporal bone and/or otic capsule involvement and posttreatment follow-up CT/magnetic resonance imaging (MRI) scans obtained at least 6 months after starting treatment. RESULTS We report eight cases of LCH of the temporal bone with three demonstrating otic capsule involvement radiographically and/or clinically. Review of posttreatment imaging revealed all three patients had complete restoration of the bony labyrinthine architecture and near or complete restoration of their hearing. CONCLUSIONS Though LCH of the temporal bone is a common site within the spectrum of the disease, involvement of the otic capsule remains rare. Here, we report the largest series of otic capsule involvement by LCH and investigate whether both architecture and hearing are recovered with appropriate treatment. Lastly, restoration of the bony architecture of the labyrinth suggests the mechanism of LCH is demineralization and not ablative.
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Yavas US, Incesulu A, Acikalin M, Calisir C, Adapinar B. Eosinophilic granuloma of the temporal bone with extensive bilateral otic capsule involvements: Incomplete reossification despite theraphy. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/j.pedex.2009.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Prognostic indicators for sensorineural hearing loss in temporal bone histiocytosis. Int J Pediatr Otorhinolaryngol 2009; 73:1616-20. [PMID: 19671478 DOI: 10.1016/j.ijporl.2009.07.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Revised: 07/10/2009] [Accepted: 07/14/2009] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Our review aims: (1) to highlight the suspicion of sensorineural hearing loss (SNHL) in temporal bone Langerhans' cell histiocytosis (LCH); (2) to assess the evolution of SNHL in this pathology; (3) to identify radiologic findings of the otic capsule invasion by LCH; (4) to determine prognostic factors for SNHL in temporal bone LCH. METHODS We performed a literature review through MEDLINE for SNHL in temporal bone LCH related articles that were published between 1954 and 2008. We identified 12 related studies of which 18 patients were noted. We also added our case to this series. The information from the reports was analyzed to characterize the clinical and demographic data and to focus on the sensorineural hearing aspect of the disease and on the damage of the semicircular canals (SCC) and the cochlea. RESULTS Ten percent of patients with temporal bone LCH presented SNHL. The mean age of patients is 3.5 years among children and 35.5 years among adults. Male to female ratio is 1:1.14. There were 13 unilateral cases, 6 bilateral cases and 1 case of multisystemic histiocytosis. Cochlea and SSCs were involved in 4 and 20 temporal bones, respectively. The lateral SCC is the most frequently eroded canal. In 23 ears hearing level was reported: 15 ears had a SNHL and the remaining was a mixed or a conductive hearing loss type. 10 ears suffered from a profound hearing loss and none of them improved after treatment regardless otic capsule affected structures. In all cases of normal hearing, moderate hearing loss and severe hearing loss before treatment cochlea have not been affected. However a single or two semicircular canals invasions have been noted. Where it is reported (15 out of 25 temporal bone) there was a radiological healing of the otic capsule lesion after treatment. Remineralization occurs 6 months after treatment. CONCLUSION In LCH, hearing loss level before treatment can be considered as a prognostic indicator for hearing in response to treatment. Even though bone mineralization is essential for a hearing improvement, radiological healing is not a prognostic factor for better hearing level after treatment.
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Thelen A, Weikert S, Schrom T, Sedlmaier B. [Histiocytosis of Langerhans cells. Simultaneous manifestation in both mastoid cavities]. HNO 2009; 57:1029-32. [PMID: 19384539 DOI: 10.1007/s00106-008-1862-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Histiocytosis X (Langerhans cells) is a rare disease with different forms of manifestation in the head and neck, which mostly occurs in children. We report the case of a 52-year-old male patient from Saudi Arabia who presented in the out-patient department of the University Hospital Charité Berlin with therapy-resistant otitis externa. ENT examination additionally showed nasal polyps. A paranasal computed tomography scan revealed as an incidental finding a mass forming tumor in both mastoids with osseous destruction of the posterior cranial fossa. Histological evaluation of the suspected tissue revealed histiocytosis X in both mastoids. After exclusion of a systemic disease local low-dose radiotherapy with 9 Gy (3x3 Gy) of the mastoid cavities was administered.
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Affiliation(s)
- A Thelen
- Klinik für Hals-, Nasen-, Ohrenkrankheiten, Charité-Universitätsmedizin Berlin, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin.
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Langerhans' cell histiocytosis of the temporal bone: successful treatment of sensorineural hearing loss with low-dose radiotherapy. The Journal of Laryngology & Otology 2008; 123:676-9. [DOI: 10.1017/s0022215108002995] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:To present the successful treatment of sensorineural hearing loss secondary to Langerhans' cell histiocytosis with low-dose radiotherapy, and also the disparity between radiological resolution of Langerhans' cell histiocytosis lesions and lack of sensorineural hearing loss improvement, accompanied by a review of the literature on otolaryngological manifestations and management of Langerhans' cell histiocytosis.Case report:Langerhans' cell histiocytosis is a multisystem disease which frequently causes osseous lesions in the temporal bones. Hearing loss is usually conductive but may be sensorineural with lesions of the petrous temporal bone. We present a case of sensorineural hearing loss secondary to Langerhans' cell histiocytosis affecting the labyrinth and internal auditory meatus, which resolved following radiotherapy. Contralateral sensorineural hearing loss in the same patient, previously treated with chemotherapy, did not resolve despite radiological resolution of the temporal bone lesions.Conclusion:We suggest that timely radiotherapy for treatment of sensorineural hearing loss secondary to Langerhans' cell histiocytosis is an appropriate treatment option.
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Langerhans' cell histiocytosis of the temporal bone in children. Int J Pediatr Otorhinolaryngol 2008; 72:775-86. [PMID: 18355926 DOI: 10.1016/j.ijporl.2008.02.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2007] [Accepted: 02/04/2008] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Langerhans' cell histiocytosis (LCH) is a rare pathology that implies an abnormal proliferation of these kinds of cells associated with a granular infiltration that affects different structures of the human body, including the temporal bone. The authors present their series of LCH of the temporal bone in children at the Sainte-Justine university hospital. The twofold objective of this study is to illustrate the clinical presentation, management and prognosis of this disease, and to compare these results with previously reported series. METHODS A retrospective study was conducted between 1984 and 2007 with patients diagnosed and treated for a LCH of the temporal bone at the Sainte-Justine university hospital, a paediatric tertiary care center. A chart review was performed to obtain demographic, clinical, paraclinical, and therapeutic data. They were analysed and compared to other published series. Through a MEDLINE query, we found that since 1966, 50 articles dealing with a LCH of the temporal bone have been published. RESULTS Fifty-nine cases of LCH were diagnosed and among them, 10 children had temporal bone involvement. They were four females and six males with a mean age of 3.28 years. The two most frequent clinical manifestations were the presence of a mass in the temporal region (70%) and otitis (60%). Two of our patients had a unifocal lesion of the temporal bone implicated. Eight patients had a multisystem involvement among which, two showed evidence of organ dysfunction. In 80% of cases, the diagnosis was made by immunohistochemical findings of the S-100 protein and/or the CD1 antigen. The common radiological finding on a skull CT scan is a lytic lesion in the temporal bone. Seven patients were treated by chemotherapy, two were treated by radiotherapy as a primary treatment, and one received radiotherapy for a recurrence on the pituitary gland. Finally, one patient was treated with local steroid injections. Two patients had a recurrence. All our patients were in total remission on a mean average of 1.6 years after the diagnosis. Our results concord with other studies in which the prognosis of unifocal bone disease is excellent and children with a multifocal disease have a survival rate of 65-100%. CONCLUSION LCH is a rare disease. A high-index suspicion should be raised in the context of a temporal mass, chronic otitis, and otorrhea. A biopsy is recommended in the presence of a temporal bone lytic lesion. Chemotherapy is the preferred therapeutic modality.
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Dong-xiao N, Hui-tu N, An-zhou T, Ruo-ze C. Langerhans' Cell Histiocytosis (Histiocytosis X) of the Temporal Bone. J Otol 2007. [DOI: 10.1016/s1672-2930(07)50007-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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del Río L, Lassaletta L, Martínez R, Sarriá MJ, Gavilán J. Petrous Bone Langerhans Cell Histiocytosis Treated with Radiosurgery. Stereotact Funct Neurosurg 2007; 85:129-31. [PMID: 17228179 DOI: 10.1159/000098528] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Langerhans cell histiocytosis (LCH) is a rare disease that may show as a solitary or multifocal lesion of bone, soft tissue or viscera. Involvement of the temporal bone has been described in 15-61% of patients with LCH, usually in association with multisystemic involvement. We report the case of a 30-year-old man presenting with vertigo and fluctuating hearing loss caused by monosystemic LCH of the left petrous bone. The patient was treated with radiosurgery (covering dose 10 Gy at 85% isodose, maximum dose 11.76 Gy). Two years after treatment, no evidence of recurrent disease was found in the CT scan or MRI. We discuss the treatment of temporal bone LCH, traditionally based on surgery, low-dose radiation therapy and intralesional steroids. To our knowledge, this is the first reported case of LCH of the petrous bone successfully treated with radiosurgery. This approach may be interesting in cases of LCH located on nonaccessible areas of the temporal bone.
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Affiliation(s)
- Laura del Río
- Department of Otolaryngology, La Paz University Hospital, Madrid, Spain.
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