Radiotherapy for Langerhans cell histiocytosis with paraplegia: A rare oncologic emergency case report in infancy and literature review.
Brain Dev
; 40(10): 952-955, 2018 Nov.
Article
en En
| MEDLINE
| ID: mdl-29907475
ABSTRACT
BACKGROUND:
Langerhans cell histiocytosis (LCH) is a clonal disease with focal or disseminated lesions that may compress the surrounding tissues, including the spinal cord. Because few reports have described the spinal symptoms as the first manifestation of pediatric LCH, the long-term neurological outcomes remain unclear. CASE REPORT AND LITERATURE REVIEW We report a 21-month-old boy who presented with sudden-onset paraplegia. Imaging analyses revealed that osteolytic lesions and epidural tumors compressing the spinal cord at the T7-9 vertebrae. Twelve days after he developed leg weakness, emergency radiotherapy was started after a tumor biopsy. During the course of radiotherapy, paralysis steadily ameliorated. After we excluded infections and determined the pathological diagnosis of LCH, multi-drug chemotherapy was started. Apparent improvement in his complete paraplegia was observed after a total 15â¯Gy of radiotherapy and subsequent chemotherapy, leaving no neurological sequelae at 4â¯years of age. Through a literature search of studies published from 1980 to 2017, we found that children with LCH showed a generally favorable recovery from neurological dysfunction after the acute phase of spinal symptoms.CONCLUSION:
This report underscores the utility of emergency radiotherapy for the neurological recovery of spinal LCH in infants. Our long-term observation further denotes the value of this treatment in terms of the intact survival with preserved motor functions and physical growth.Palabras clave
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Neoplasias Epidurales
/
Histiocitosis de Células de Langerhans
Tipo de estudio:
Etiology_studies
Límite:
Humans
/
Infant
/
Male
Idioma:
En
Revista:
Brain Dev
Año:
2018
Tipo del documento:
Article
País de afiliación:
Japón