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Table 5 Management and outcome of bone lesions in cases (n = 64) of case reports

From: Unusual sites of bone involvement in Langerhans cell histiocytosis: a systematic review of the literature

Management

n (%) / involved sites

References

Unifocal (n = 44)

Multifocal (n = 11)

Multisystem (n = 9)

Total excision

18 (40.9)/skull, spine, sternum

2 (18.2)/temporal + intracranial extention + sigmoid sinus, + mandible, Both jaws

[8, 16, 18, 20, 22,23,24,25,26,27,28,29,30,31, 40, 42, 52, 57]a

Total excision + chemotherapy

2 (4.5)/spine, rib

 

1 (11.1)/petrous + SCC + middle cranial base

[34, 38, 64]

Subtotal excision + chemotherapy

1 (2.3)/skull

1 (9.1)/petrous + inner ear + sphenoid

1 (11.1)/bilateral mastoid + C2

[6, 19, 59]

Subtotal excision + radiotherapy

1 (2.3)/spine

1 (9.1)/clivus, sella + sphenoid sinus

 

[33, 60]

Radiosurgery

1 (2.3)/skull

[17]

Radiotherapy

1 (2.3)/spine

1 (9.1)/temporal + clivus + occipital + atlantoaxial joint

[32, 54]

Radiotherapy + epidural steroid injection

1 (2.3)/ [51]

[51]

Systemic chemotherapy

2 (4.5)/clavicle, skull

4 (36.3) /odontoid process + C2 + femur, bilateral petrous + bilateral labyrinth, both jaws + petrous apex + otic capsule + clivus, sternum + greater trochanter + tibia

3 (33.3)/bilateral parietal + both jaws, maxillary sinus, Ilium + T6 + 6th rib

[7, 21, 53, 55, 58, 61, 62, 65, 66]

Chemotherapy + radiotherapy

1 (11.1)/temporal with involving dura

[3]

Analgesics, + intralesional steroid injection + chemotherapy

1 (11.1)/both femur

[66]

Curettage

9 (20.5)/clavicle, sternum, humerus, acetabulum, metatarsal

[14, 36,37,38, 41, 43, 49, 50]b

Curettage + radiotherapy

2 (4.5)/sternum, metacarpal

[15, 45]

Observation

4 (9.0)/sternum, clavicle, scapula, ilium

[4, 39, 44]

Conservative

2 (4.5)/scapula, spine

1 (9.1)/radius, ulna

1 (11.1)/femur

[2, 35, 46, 63]

Not determined

1 (9.1)/both jaws

1 (11.1)/sacral

[56, 67]

Outcome after initial treatment

  

n (%)

 

Complete recovery without complication

33 (75.0)

6 (54.5)

3 (33.3)

 

Complete recovery with permanent complication

1 (2.3)

3 (27.3)

2 (22.2)

 

Recurrence

1 (2.3)

1 (9.1)

1 (11.1)

 

Lost follow- up

1 (2.3)

0 (0.0)

0 (0.0)

 

Not determined

8 (18.1)

1 (9.1)

2 (22.2)

 

Death

0 (0.0)

0 (0.0)

1 (11.1)

 
  1. SCC, semicircular canal; C2, second cervical spine; T6, sixth thoracic spine
  2. a 3 cases, b 2 cases