title: Management of eosinophilic granuloma occurring in the appendicular skeleton in children.
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.
authors.affiliation: Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea.
authors.forename: Ilkyu
authors.initials: I
authors.lastname: Han
authors.forename: Eun Seok
authors.initials: ES
authors.lastname: Suh
authors.forename: Sang-Hoon
authors.initials: SH
authors.lastname: Lee
authors.forename: Hwan Seong
authors.initials: HS
authors.lastname: Cho
authors.forename: Joo Han
authors.initials: JH
authors.lastname: Oh
authors.forename: Han-Soo
authors.initials: HS
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001847:Bone Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D004803:Eosinophilic Granuloma / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D011859:Radiography; D011877:Radionuclide Imaging; D012008:Recurrence
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors; D007213:Indomethacin