Francesca Di Felice1, Fabio Zaina2, Sabrina Donzelli2, Stefano Negrini3,4. 1. ISICO (Italian Scientific Spine Institute), Via Bellarmino 13/1, 20141, Milan, Italy. francesca.difelice@isico.it. 2. ISICO (Italian Scientific Spine Institute), Via Bellarmino 13/1, 20141, Milan, Italy. 3. Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. 4. IRCCS Fondazione Don Gnocchi, Milan, Italy.
Abstract
PURPOSE: The eosinophilic granuloma is a unifocal or multifocal Langerhans cell histiocytosis characterized by an expanding proliferation of Langerhans cells in bones. Skeletal LCH is a rare condition, and vertebral regeneration in cases of vertebral body collapse is even rarer. We report the case of a girl with spontaneous complete healing. METHODS AD RESULTS: A 3-year-old girl was referred for nighttime back pain, with no fever and no neurologic signs. Within a few days, she developed sudden painful restriction of all spine movements. X-ray and computed tomography (CT) of the spine showed reduced T7 vertebral body height (vertebra plana).The patient underwent T7 curettage and the histopathological exam was suggestive of LCH. Two additional skull lesions were found and therefore she underwent chemotherapy. After 7 years of follow-up, total vertebral reconstruction was observed. CONCLUSIONS: Despite the rarity of the condition and despite the rarity of vertebral body lesion resolution, total vertebral body reconstruction was observed over a 7-year period. Long-term follow-up is necessary for a better understanding of the final outcome of patients with EG.
PURPOSE: The eosinophilic granuloma is a unifocal or multifocal Langerhans cell histiocytosis characterized by an expanding proliferation of Langerhans cells in bones. Skeletal LCH is a rare condition, and vertebral regeneration in cases of vertebral body collapse is even rarer. We report the case of a girl with spontaneous complete healing. METHODS AD RESULTS: A 3-year-old girl was referred for nighttime back pain, with no fever and no neurologic signs. Within a few days, she developed sudden painful restriction of all spine movements. X-ray and computed tomography (CT) of the spine showed reduced T7 vertebral body height (vertebra plana).The patient underwent T7 curettage and the histopathological exam was suggestive of LCH. Two additional skull lesions were found and therefore she underwent chemotherapy. After 7 years of follow-up, total vertebral reconstruction was observed. CONCLUSIONS: Despite the rarity of the condition and despite the rarity of vertebral body lesion resolution, total vertebral body reconstruction was observed over a 7-year period. Long-term follow-up is necessary for a better understanding of the final outcome of patients with EG.
Entities:
Keywords:
Case report; Eosinophilic granuloma; Vertebral collapse
Authors: Wending D Huang; Xinghai H Yang; Zhipeng P Wu; Quan Huang; Jianru R Xiao; Mosong S Yang; Zhenhua H Zhou; Wangjun J Yan; Dianwen W Song; Tielong L Liu; Ningyang Y Jia Journal: Spine J Date: 2013-04-18 Impact factor: 4.166