Langerhans Cell Histiocytosis of Multiple Osseous Lesions

Abstract

We report a 5-year-old boy with Langerhans cell histiocytosis (LCH) of multiple osseous lesions. He slipped in the bathroom, and three days later, he complained of acute lumbar pain after swimming. In the L2 vertebra, MRI revealed low intensity in T1WI and high intensity in T2WI, and CT showed fracture and mass lesion with peripheral sclerosis. Conservative treatment with spinal brace was performed, and walking exercise was started six weeks after injury. A new fracture lesion in the T5 vertebra was detected by MRI three months after injury. X-ray showed vertebra plana at the T5 vertebra, and a punched-out lesion in the skull. Biopsy of the skull was performed and Langerhans cells were detected.
Chemotherapy (Ara-C, VCR, PSL) was performed for LCH of multiple osseous lesions. Six months after treatment, neither progression of vertebral collapse nor emergence of new lesions has been detected. Chemotherapy is an effective treatment for preventing tumor progression of multiple osseous LCH.