Back to Search
Start Over
Langerhans cell histiocytosis with aneurysmal bone cyst-like changes: a case-based literature review.
- Source :
-
Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery [Childs Nerv Syst] 2023 Nov; Vol. 39 (11), pp. 3057-3064. Date of Electronic Publication: 2023 Jul 31. - Publication Year :
- 2023
-
Abstract
- Background: Langerhans cell histiocytosis (LCH) is a neoplastic transformation of myeloid precursors that commonly presents as an osteolytic lesion of the long or flat bones in children. Aneurysmal bone cysts (ABC) are benign neoplasms that frequently affect the metaphysis of long bones and the spine, often revealing a rapidly expansile lesion with fluid-fluid levels. LCH with secondary ABC-like changes is a rare condition that has only been reported five times, with two presentations in the cranium. The aim of this paper is to review the etiology, clinical and radiographic presentations, and treatment of this condition, as well as to present a novel case on the topic.<br />Case Description: We describe a 5-year-old boy with a rapidly growing head mass and eye pain resulting in a diagnosis of LCH with secondary ABC-like changes. Radiography demonstrated an expansile, lytic lesion of the left parietal bone with fluid-fluid levels. A confirmatory diagnosis was made through histopathology, demonstrating an inflammatory, histiocytic infiltrate staining positive for CD1a, CD68, CD207 (Langerin), and S-100. The lesion was surgically excised, and the patient recovered without any complications.<br />Conclusion: We present a novel case of LCH with secondary ABC-like changes managed with surgical excision. While a radiographic workup with multiple imaging modalities is helpful for diagnosis, a thorough immunohistochemical analysis is essential as imaging characteristics are variable and nonspecific. Furthermore, surgical excision should be considered first-line treatment for lesions involving the skull in surgically accessible areas as it is curative, alleviates symptoms, and allows for histopathological diagnosis.<br /> (© 2023. The Author(s).)
- Subjects :
- Child, Preschool
Humans
Male
Head pathology
Radiography
Skull diagnostic imaging
Skull surgery
Skull pathology
Bone Cysts, Aneurysmal diagnostic imaging
Bone Cysts, Aneurysmal surgery
Bone Cysts, Aneurysmal complications
Histiocytosis, Langerhans-Cell complications
Histiocytosis, Langerhans-Cell diagnostic imaging
Histiocytosis, Langerhans-Cell surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1433-0350
- Volume :
- 39
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 37522932
- Full Text :
- https://doi.org/10.1007/s00381-023-06108-7