title: Langerhans' cell histiocytosis of the head and neck in children.
abstract: This is a retrospective analysis of a 29-year institutional experience with Langerhans' cell histiocytosis (LCH) in children. Cases of LCH were categorized by disease extent into three groups: group 1, with a solitary focus of LCH; group 2, with multiple non-vital organ foci; and group 3, with vital organ disease. Sixteen patients averaging 7.3 years of age and with 11.0 years of follow-up presented in group 1. One child experienced a spontaneous remission; all other children responded to local treatment. The skull was the most common site of involvement. Eight children averaging 4.6 years in age and with 8.0 years of follow-up presented in group 2; 3 children had diabetes insipidus. Treatment included radical surgery, radiotherapy, and chemotherapy; however, disease persisted in all patients. Iatrogenic complications were a significant cause of morbidity and mortality. Only 1 patient, 1 year of age, presented with lung and liver involvement (group 3). He died after a fulminant course. Current recommendations for diagnosis, evaluation, and treatment of LCH are discussed.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City 52242.
authors.forename: S I
authors.initials: SI
authors.lastname: Angeli
authors.forename: J
authors.initials: J
authors.lastname: Alcalde
authors.forename: H T
authors.initials: HT
authors.lastname: Hoffman
authors.forename: R J
authors.initials: RJ
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006646:Histiocytosis, Langerhans-Cell / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D011859:Radiography; D012075:Remission, Spontaneous; D012189:Retrospective Studies; D012886:Skull / Q000000981:diagnostic imaging / Q000473:pathology; D016896:Treatment Outcome