Treatment of Langerhans-cell histiocytosis with multiple osseous lesions: Experience from A single case

Langerhans-cell histiocytosis (LCH) is divided into Letterer-Siwe disease, Hand-Schuller-Christian disease, and Eosinophilic granuloma according to their presentations and severity. Eosinophilic granuloma is characterized by bony lesions and it affects older children or young adults. A 3-year-old boy presented with multiple osseous lesions of eosinophilic granuloma scattered over different bones. We treated the lesions of the left proximal femur and right distal femur with curettage and bone grafting. An intralesional injection of methyl-prednisolone was done for the lesions of the right distal humerus, left humeral shaft, right fibula and left glenoid fossa. Besides these, we observed lesions of the occipital skull, left pubic bone and right ilium. All of the lesions responded well to the above treatments without recurrence of previous lesions after four years of follow-up. A less invasive treatment should be suggested for osseous lesions of LCH, such as intralesional steroid injection or close observation. Curettage and bone grafting may be used for obtaining a tissue specimen for differential diagnosis. However, systemic chemotherapy or radiotherapy is not necessary for osseous lesions of LCH.