[Successful treatment with total cranial irradiation for central nervous system involvement of Langerhans cell sarcoma during chemotherapy]

Rinsho Ketsueki. 2016 Jan;57(1):25-30. doi: 10.11406/rinketsu.57.25.
[Article in Japanese]

Abstract

Langerhans cell sarcoma (LCS) is an extremely rare neoplasm of Langerhans cell origin characterized by systemic involvement and a poor prognosis. There are, however, few reports of LCS with central nervous system involvement. We experienced a patient with LCS recurrence in the brain that appeared during systemic chemotherapy. The brains lesions eventually responded to total cranial irradiation. A 60-year-old female presented with systemic lymphadenopathy. LCS was diagnosed based on neck lymph node biopsy findings. Two cycles of ESHAP induced marked regression of her lymphadenopathy, but FDG-PET/CT scan revealed new lesions in the central nervous system and her disorientation gradually worsened. We administered 37.5 Gy of total cranial irradiation which improved her consciousness and shrank the brain tumors as demonstrated by MRI. The patient's clinical course indicates that radiation therapy may be effective for central nervous system involvement of LCS even if the lesion is resistant to systemic chemotherapy.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biopsy
  • Brain Neoplasms / pathology
  • Brain Neoplasms / therapy*
  • Chemoradiotherapy
  • Cisplatin / therapeutic use
  • Cranial Irradiation
  • Cytarabine / therapeutic use
  • Etoposide / therapeutic use
  • Fatal Outcome
  • Female
  • Humans
  • Langerhans Cell Sarcoma / therapy*
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Positron-Emission Tomography
  • Tomography, X-Ray Computed

Substances

  • Cytarabine
  • Etoposide
  • Cisplatin
  • Methylprednisolone

Supplementary concepts

  • ESAP protocol