Clin Orthop Surg.  2009 Jun;1(2):63-67. 10.4055/cios.2009.1.2.63.

Management of Eosinophilic Granuloma Occurring in the Appendicular Skeleton in Children

Affiliations
  • 1Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea. hankim@snu.ac.kr

Abstract

BACKGROUND: We compared indomethacin therapy with the more aggressive approaches of anti-cancer chemotherapy and surgery in the treatment of isolated Langerhans cell histiocytosis (LCH) of bone in children.
METHODS
Comparisons were made with respect to healing of the lesion without recurrence, time to radiological healing of the lesion, time to functional recovery, and complications related to treatment.
RESULTS
Complete radiologic healing of the lesion (mean, 15.3 months) and functional recovery (mean, 5.6 months) were observed in all patients treated with either approach. No significant differences were noted in the time to complete radiologic healing or the time to functional recovery between the two groups. There were no recurrences with either approach until the last follow-up (mean, 56 months). Complications were common with anti-cancer chemotherapy, but indomethacin was well-tolerated.
CONCLUSIONS
Indomethacin seems to be effective for treating isolated LCH of bone in children. Hence, morbidities associated with aggressive treatment approaches such as anti-cancer chemotherapy or surgery can be avoided.

Keyword

Langerhans cell histiocytosis; Indomethacin; Children
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