Unifocal Langerhans cell histiocytosis of bone: percutaneous navigational bipolar radiofrequency ablation for curative treatment

Tomasian, Anderanik; Hillen, Travis J.; Jennings, Jack W.

doi:10.1016/j.clinimag.2020.11.031

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…Isolated lesions have different treatment options, while multisystemic or disseminated disease usually requires chemotherapy [8]. Some studies have even demonstrated that minimally-invasive radiofrequency ablation may support safe and effective treatment for unifocal LCH bone lesions [17]. LCH presentations may not be benign, with disseminated disease associated with increased mortality and recurrence rates [18][19][20][21].…”

Section: Discussionmentioning

confidence: 99%

“…While the pelvis is not an uncommon site of LCH lytic lesions in adult studies, few studies have characterized and reviewed the eventual outcomes after treatment at these sites, especially in pediatric populations. The few studies looking at isolated pelvic lesions were all case reports in an older patient population or investigations characterizing radiographic findings for differential diagnosis [10][11][12][13][14][15][16][17]. The incidence and sequential investigation of outcomes of this rare disorder at the pelvic site are poorly defined and followed.…”

Section: Introductionmentioning

confidence: 99%

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Treatment and Outcomes of Unifocal and Multifocal Osseous Pelvic Langerhans Cell Histiocytosis Lesions in a Pediatric Population

Mitchell¹,

Ezeokoli²,

Borici³

et al. 2022

Cureus

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Introduction Langerhans cell histiocytosis (LCH) is a rare, clonal disorder characterized by proliferation and tissue infiltration by myeloid dendritic cells, most commonly occurring in pediatric populations. It often manifests as skeletal lesions with possible pelvic involvement. Few studies have characterized and reviewed outcomes after treatment of isolated pelvic LCH lesions. Methods A retrospective single-institution review was conducted on diagnoses of patients younger than 18 with a diagnosis of unifocal or multifocal skeletal LCH lesions involving the pelvis. Clinical presentations, lesion sites, focal classification, radiographic findings, treatments, complications, and recurrence rates were reviewed. Results Twenty patients had unifocal or multifocal LCH pelvic lesions (11 males, nine females). The median age at diagnosis was 3.5 years (0.8-21.6). Eight cases (40%) involved unifocal lesions, and twelve (60%) involved multifocal lesions, with the most common associated skeletal disease occurring at the ilium. 100% of cases had a lytic bone lesion with no pathologic fractures. All cases were treated nonoperatively with chemotherapy medications, corticosteroids, or observation alone. 75% of cases were treated with chemotherapy with a 100% resolution rate. The median length of follow-up was 4.5 years (0.4-16.7). Conclusion Our study found that chemotherapy alone or chemotherapy with corticosteroid supplementation are appropriate options for unifocal pelvic LCH lesions. In contrast, pelvic lesions that are part of a multifocal presentation may be managed adequately with varied chemotherapy regimens. Corticosteroid therapy and observation alone may also be reasonable for a single organ system, multifocal, skeletal lesions that are anatomically accessible for biopsy and small in number or size.

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