Treatment of recurrent eosinophilic granuloma with systemic therapy

Alice Song, Thomas Johnson, Sander Dubovy, Stuart Toledano

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)140-144
Number of pages5
JournalOphthalmic Plastic and Reconstructive Surgery
Volume19
Issue number2
DOIs
StatePublished - Mar 1 2003

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Eosinophilic Granuloma
Magnetic Resonance Imaging
Vinca Alkaloids
Therapeutics
Antimetabolites
6-Mercaptopurine
Langerhans Cell Histiocytosis
Curettage
Vinblastine
Frozen Sections
Eyelids
Prednisone
Combination Drug Therapy
Methotrexate
Steroids
Tomography
Pediatrics
Biopsy
Recurrence

ASJC Scopus subject areas

  • Ophthalmology
  • Surgery

Cite this

Treatment of recurrent eosinophilic granuloma with systemic therapy. / Song, Alice; Johnson, Thomas; Dubovy, Sander; Toledano, Stuart.

In: Ophthalmic Plastic and Reconstructive Surgery, Vol. 19, No. 2, 01.03.2003, p. 140-144.

Research output: Contribution to journalArticle

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