Management of eosinophilic granuloma occurring in the appendicular skeleton in children.
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.
Han
Ilkyu
I
Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea.
Suh
Eun Seok
ES
Lee
Sang-Hoon
SH
Cho
Hwan Seong
HS
Oh
Joo Han
JH
Kim
Han-Soo
HS
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
D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors; D007213:Indomethacin