A rare presentation of Erdheim Chester disease in a pediatric patient subsequently cured on the LCH III protocol

Background

Erdheim Chester disease (ECD) is very rare in pediatrics with no standard treatment guidelines. Here we present the case of a pediatric ECD patient who was cured with a Langerhan cell histiocytosis (LCH) directed chemotherapy protocol.

Aim

The aim of the report was to publish this rare presentation of ECD in pediatrics and highlight the complete response obtained to treatment.

Methods

The details of the patient were extracted by a retrospective review of her clinical records.

Results (Case)

An 11 years old girl presented with fever and bone pain. On investigating she had multiple lytic bony lesions scattered throughout her skeleton. A biopsy from one of the bone lesions confirmed the diagnosis to be ECD. ECD is very rare in pediatrics and this case adds to the existing list of 11 previously reported ones. Also, worth mention is the fact that the child presented with isolated skeletal involvement in form of multiple osteolytic lesions. The child was started on the LCH‐III protocol on which she achieved a cure.

Conclusion

Lytic bone lesions in a child may be present in ECD. A subset of ECD may have good response to LCH like chemotherapy.

Unusual Presentation of Rare Cardiac Tumor: The Role of F-18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

Primary cardiac tumors are rare with angiosarcoma being the most common among malignant cardiac tumor. We present a case of 30-year-old female patient in whom F-18-fluorodeoxyglucose positron emission tomography/computed tomography demonstrated a necrotic mass in right atrium with multiple fluorodeoxyglucose avid lesions in both upper and lower alveolus, liver, multiple bones, and bilateral lungs. Patient underwent biopsy from gum swelling which revealed metastatic angiosarcoma.