Langerhans' Cell Histiocytosis of the Spine in Children

Levine, Stuart E.; Dormans, John P.; Meyer, James S.; Corcoran, Thomas A.

doi:10.1097/00003086-199602000-00040

Cited by 52 publications

(22 citation statements)

References 20 publications

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“…Compiling data from the eight largest case series of the spinal LCH reveals that 49 of 180 cases (27.2%) had multiple vertebrae lesions [3,5,11,13,20,23,26,27,35].…”

Section: Meta-analysis Literature Review and Discussionmentioning

confidence: 99%

“…Therapy includes observation, immobilization, NSAIDs [7,15,20,28], chemotherapy [12,34], radiotherapy, intralesional infiltration of steroids and surgery [30]. Recent case reports show encouraging results using the tumor necrosis factor-a (TNF-a) antagonist etanercept, the PPAR-c antagonist pioglitazone, 2-Cda22 and the COX-2 antagonist rofecoxib to treat single-system disease [15].…”

Section: Treatment and Outcomementioning

confidence: 99%

“…Radiation therapy used to be popular for solitary bony lesions of LCH, but is abandoned by most authors for two possible complications, secondary malignancy and vertebral growth disturbance [4,13,20]. We still prefer radiotherapy for severe bony destruction and/or mild neurological deficit for two reasons.…”

Section: Radiotherapymentioning

confidence: 99%

“…A search of the MEDLINE databank located 13 studies and totally 50 cases of LCH with multiple spinal lesions [1,3,5,11,13,20,21,23,26,27,[32][33][34][35]. We reported five additional cases and a meta-analysis of all cases was also performed.…”

Section: Introductionmentioning

confidence: 99%

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Langerhans cell histiocytosis with multiple spinal involvement

et al. 2010

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To stress the clinical and radiologic presentation and treatment outcome of Langerhans cell histiocytosis (LCH) with multiple spinal involvements. A total of 42 cases with spinal LCH were reviewed in our hospital and 5 had multifocal spinal lesions. Multiple spinal LCH has been reported in 50 cases in the literature. All cases including ours were analyzed concerning age, sex, clinical and radiologic presentation, therapy and outcome. Of our five cases, three had neurological symptom, four soft tissue involvement and three had posterior arch extension. Compiling data from the eight largest case series of the spinal LCH reveals that 27.2% multiple vertebrae lesions. In these 55 cases, there were 26 female and 29 male with the mean age of 7.4 years (range 0.2-37). A total of 182 vertebrae were involved including 28.0% in the cervical spine, 47.8% in thoracic and 24.2% in the lumbar spine. Extraspinal LCH lesion was documented in 54.2% cases, visceral involvement in 31.1% and vertebra plana in 50% cases. Paravertebral and epidural extension were not documented in most cases. Pathological diagnosis was achieved in 47 cases including 8 open spine biopsy. The treatment strategy varied depending on different hospitals. One patient died, two had recurrence and the others had no evidence of the disease with an average of 7.2 years (range 1-21) of follow-up. Asymptomatic spinal lesions could be simply observed with or without bracing and chemotherapy is justified for multiple lesions. Surgical decompression should be reserved for the uncommon cases in which neurologic compromise does not respond to radiotherapy or progresses too rapidly for radiotherapy.

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“…Compiling data from the eight largest case series of the spinal LCH reveals that 49 of 180 cases (27.2%) had multiple vertebrae lesions [3,5,11,13,20,23,26,27,35].…”

Section: Meta-analysis Literature Review and Discussionmentioning

confidence: 99%

Section: Treatment and Outcomementioning

confidence: 99%

Section: Radiotherapymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Langerhans cell histiocytosis with multiple spinal involvement

et al. 2010

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“…LCH of the spine usually develops in the vertebral body with an osteolytic appearance and leads to what is classically known as "vertebra plana" [9,15]. Reports on adjacent paravertebral soft tissue mass in LCH of the spine are rare in the literature [10,16,18,25].…”

Section: Introductionmentioning

confidence: 99%