Treatment of Recurrent Eosinophilic Granuloma With Systemic Therapy

Treatment of Recurrent Eosinophilic Granuloma With Systemic Therapy
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全身治疗复发性嗜酸性肉芽肿

DOI:
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发表时间:
2003
影响因子:
2
通讯作者:
S. Toledano
S. Toledano
中科院分区:
医学4区
文献类型:
--
作者:
A. Song;T. Johnson;Sander R. Dubovy;S. Toledano

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目的探讨复发性嗜酸性肉芽肿的全身治疗方法。方法对朗格汉斯细胞组织细胞增多症病例进行回顾性分析。结果1例9岁男童右上睑肿痛。计算机断层扫描显示右眶上外侧肿块伴骨质侵蚀。冰冻切片评价与嗜酸性肉芽肿一致。进行活检和刮除。全身性检查未发现眶外病变。术后6周眼眶肿块复发经核磁共振(MRI)证实。强的松和长春碱治疗4周后,MRI显示眼眶病变面积明显减小。开始了6-巯基嘌呤和甲氨蝶呤的额外治疗,6个月后MRI显示病变完全消退。结论复发性嗜酸性肉芽肿的治疗具有挑战性。目标是有效地治愈病变,使短期和长期的副作用降到最低。全身类固醇、长春花生物碱、抗代谢物和抗叶酸是首选,因为它们的毒性和诱变性较小。联合化疗与儿科血液学家/肿瘤学家的治疗似乎是治疗复发性疾病的有效方法。
Purpose To describe the systemic treatment of recurrent eosinophilic granuloma. Methods Case report and review of Langerhans cell histiocytosis. Results A 9-year-old boy had painful, right upper eyelid swelling. A computed tomography scan showed a right superolateral orbital mass with evidence of bony erosion. Frozen section evaluation was consistent with eosinophilic granuloma. Biopsy and curettage were performed. Systemic work-up was negative for extraorbital disease. Recurrence of the orbital mass 6 weeks after surgery was confirmed by magnetic resonance imaging (MRI). Four weeks after treatment with prednisone and vinblastine, MRI showed a marked decrease in the size of the orbital lesion. Additional treatment with 6-mercaptopurine and methotrexate was initiated, and MRI 6 months later showed complete resolution of the lesion. Conclusions The treatment of recurrent eosinophilic granuloma is challenging. The goal is to effectively cure the lesion with minimal short-term and long-term side effects. Systemic steroids, vinca alkaloids, antimetabolites, and antifols are preferred because they have less toxicity and mutagenicity. Combination chemotherapy used in conjunction with treatment by a pediatric hematologist/oncologist appears to be an effective method of treating recurrent disease.
眼眶组织细胞疾病。
DOI: --
发表时间: 1984
影响因子: --
作者:
Char,DH;Ablin,A;Beckstead,J
通讯作者: Beckstead,J