Medical Management of Eosinophilic Granuloma of the Cervical Spine

Levy, Elad I.; Scarrow, Alan M.; Hamilton, Ronald C.; Wollman, Michael R.; Fitz, Charles R.; Pollack, Ian F.

doi:10.1159/000028853

Cited by 20 publications

(19 citation statements)

References 7 publications

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“…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%

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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Section: Introductionmentioning

confidence: 99%

Langerhans cell histiocytosis with multiple spinal involvement

et al. 2010

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“…Embora tenham sido relatados casos em pacientes do gênero feminino 2,7,8 . A proporção entre homens e mulheres com GE é de aproximadamente 2:1 4 . Oitenta por cento dos pacientes com diagnósti-co de GE têm menos de 20 anos 4,8,10 .…”

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“…A proporção entre homens e mulheres com GE é de aproximadamente 2:1 4 . Oitenta por cento dos pacientes com diagnósti-co de GE têm menos de 20 anos 4,8,10 . Foram descritos raros casos em adultos 2,8 .…”

Section: Discussionunclassified

“…Foram descritos raros casos em adultos 2,8 . A dor é o sintoma mais frequente 4,6,11 e aparece em 87% do casos 3,4 . Podem ocorrer sinais flogísticos no local da lesão 6 .…”

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“…After six months, this protocol was repeated associaded to methotrexate.The patient improved and had no new symptoms in a follow-up of 36 months. Granuloma eosinofílico é doença descrita como condição benigna de proliferação histiocitária localizada ou multifocal, acometendo, principalmente, os ossos do crânio, costelas, mandíbulas, fêmur e coluna vertebral, sendo mais frequente em crianças e adolescentes [1][2][3][4][5] . Representa 50-60% de um grupo de enfermidades denominadas histiocitose X, cujo denominador comum é o desenvolvimento de lesões granulomatosas em diversos tecidos 6,7 .…”

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Granuloma eosinofílico de coluna cervical: relato de caso

Filho

Aguiar

Almeida

et al. 2003

Arq. Neuro-Psiquiatr.

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RESUMO -Granuloma eosinofílico (GE) é condição benigna de proliferação histiocitária localizada ou multifocal. A ocorrência de lesões na coluna cervical pode variar entre 1,5% e 20% dos casos de GE. Relatamos caso de menina de sete anos de idade e história de cervicalgia há cerca de um mês, torcicolo persistente e postura viciosa do pescoço, com desvio cefálico para esquerda. A tomografia computadorizada revelou lesão expansiva, osteodestrutiva ao nível da hemilâmina esquerda de C2, com invasão do canal raquiano e do plano muscular a este nível. A paciente foi submetida a laminectomia cervical com retirada da lesão com pós-operatório favorável, e melhora da sintomatologia. Foi feita quimioterapia com prednisona, vinblastina e etoposide. Após seis meses, o protocolo foi mantido e associado a metotrexate. A paciente segue sem recidiva há 36 meses.PALAVRAS-CHAVE: granuloma eosinofílico, histiocitose-X , coluna cervical, torcicolo.Eosinophilic granuloma of the cervical spine: case report. Eosinophilic granuloma of the cervical spine: case report. Eosinophilic granuloma of the cervical spine: case report. Eosinophilic granuloma of the cervical spine: case report. Eosinophilic granuloma of the cervical spine: case report. ABSTRACT-Eosinophilic granuloma (EG) is a benign condition of histocytes proliferation localized or multifocal.It is presents in the cervical spine in 1.5%-20% of the cases of EG. We report the case of a seven-year-old girl that presented with a one month history of cervical pain, persistent wryneck and vicious posture of the neck. A computerized tomography was performed and confirmed the presence of spreading lesion, ostheodestructive to the level of the left laminae of C2, with invasion of the spine and the muscular tissue. A laminectomy was underwent for removal of the lesion. The patient had a good post-operative recovery with improvement of the symptoms. Chemotherapy with prednisone, vinblastine and ethoposide was administred. After six months, this protocol was repeated associaded to methotrexate.The patient improved and had no new symptoms in a follow-up of 36 months.KEY WORDS: eosinophilic granuloma, histicyocitosis X, cervical spine, wryneck. Granuloma eosinofílico é doença descrita como condição benigna de proliferação histiocitária localizada ou multifocal, acometendo, principalmente, os ossos do crânio, costelas, mandíbulas, fêmur e coluna vertebral, sendo mais frequente em crianças e adolescentes [1][2][3][4][5] . Representa 50-60% de um grupo de enfermidades denominadas histiocitose X, cujo denominador comum é o desenvolvimento de lesões granulomatosas em diversos tecidos 6,7 . Estas enfermidades seriam diferentes expressões do mesmo processo patológico de origem ainda desconhecida 3,6,8 . O presente relato tem como finalidade lembrar que uma criança com torcicolo persistente e achados de lesão óssea em coluna cervical, sem história prévia de trauma, pode apresentar granuloma eosinofílico. CASOMenina de 7 anos, admitida com história de cervicalgia há um mês, torcicolo persistente e post...

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Spinal Column Tumors

Whitehead¹,

Illner²

Neuro-Oncology of CNS Tumors

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Medical Management of Eosinophilic Granuloma of the Cervical Spine

Cited by 20 publications

References 7 publications

Langerhans cell histiocytosis with multiple spinal involvement

Langerhans cell histiocytosis with multiple spinal involvement

Granuloma eosinofílico de coluna cervical: relato de caso

Spinal Column Tumors

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