title: Langerhans cell histiocytosis of the cranial base: is low-dose radiotherapy effective?
abstract: Introduction. Langerhans cell histiocytosis (LCH) is a rare disease of unknown etiology with different clinical features. A standardised treatment has not been established so far. Case Report. We report a case of a 28-year-old patient who initially presented with hypesthesia of the fifth cranial nerve and pain of the left ear. Diagnosis showed a tumour localised in the cranial base with a maximum diameter of 4.1 cm. The diagnosis of LCH was confirmed histologically by biopsy. Diagnostic workup verified the cranial lesion as the sole manifestation of LCH. A total dose of 9 Gy (single dose 1.8 Gy) was delivered. The symptoms dissolved completely within 6 months after radiation; repeated CT and MRI scans revealed a reduction in size of the lesion and a remineralisation of the bone. After a followup of 13 years the patient remains free of symptoms without relapse or any side effects from therapy. Discussion. Due to the indolent course of the disease with a high rate of spontaneous remissions the choice of treatment strongly depends on the individual clinical situation. In the presented case low-dose radiotherapy was sufficient to obtain long-term local control in a region with critical structures and tissues.
authors.affiliation: Department of Radiation Oncology, Hannover Medical School, Carl-Neuberg-Street 1, 30625 Hannover, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Meyer
authors.forename: Michael
authors.initials: M
authors.lastname: Stark
authors.forename: Johann H
authors.initials: JH
authors.lastname: Karstens
authors.forename: Hans
authors.initials: H
authors.lastname: Christiansen
authors.forename: Frank
authors.initials: F
authors.lastname: Bruns