Published in:
01-09-2015 | Case Report
Multifocal soft tissue Langerhans’ cell histiocytosis treated with PET-CT based conformal radiotherapy
Published in: Japanese Journal of Radiology | Issue 9/2015
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Introduction
Langerhans’ cell histiocytosis (LCH) is a proliferative disorder of Langerhans cells, which is seen extremely rarely in adults. Conventional imaging modalities, such as skeletal surveys and bone scans, were accepted to be standard methods for diagnosis; however, 18-fluorodeoxyglucose positron emission tomography (PET-CT) has been increasingly used.
Methods
We report on a 33-year-old female patient with disseminated LCH treated with radiotherapy and systemic chemotherapy where PET-CT has been used for defining the extent of the disease, RT planning and assessment of treatment response during follow-up.
Results
The patient was treated with 24 Gy 3-dimensional conformal radiotherapy (RT), given as 2 Gy a day, 5 days a week. The patient was also treated with systemic prednisolone 20 mg/m2, concurrently. The chemotherapeutic regimen switched to cytosine-arabinoside with a dose of 100 mg/m2 subcutaneously daily for 4 days, vincristine 1.5 mg/m2 given on the 1st day and prednisolone 20 mg/m2 for 4 cycles. After local RT with adjuvant chemotherapy, the patient was alive for 54 months and remained disease-free at last visit.
Conclusion
RT is a treatment choice in multi-system LCH as well as solitary lesions. Low-dose RT is adequate to control large masses of LCH including soft tissue and lymph nodes.