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Case Reports in Oncological Medicine
Volume 2017, Article ID 9064326, 3 pages
Case Report

An Aggressive Form of Langerhan Cell Histiocytosis in an Adult: Therapeutic Challenges

1Department of Internal Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, USA
2Department of Pathology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, USA
3Department of Haematology and Oncology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, USA

Correspondence should be addressed to Karan Seegobin; moc.liamtoh@nibogeesnarak

Received 2 August 2017; Accepted 8 November 2017; Published 3 December 2017

Academic Editor: Jose I. Mayordomo

Copyright © 2017 Karan Seegobin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Langerhans cell histiocytosis (LCH) is rare in adults. Regular follow-up is mandatory due to reoccurrence. A 35-year-old male with an incidental left iliac bone lesion was diagnosed with LCH. He later became symptomatic with hip pain and spread of the disease. Despite excision of the symptomatic iliac lesion, he had progression while on cytarabine and nivolumab, evidenced by increased bone pain and involvement of other bones on imaging. He underwent excision of the jaw lesion followed by vinblastine; he was pain free and had stable disease on PET imaging after 3 months. LCH is an uncommon neoplasia. Treatment is reserved for symptomatic patients while asymptomatic patients are observed. Follow-up is imperative due to the risk of reoccurrence. Despite surgical treatment together with one of the front-line agents for refractory disease, in this case cytarabine, he still had progression of the disease. Furthermore, the trial of nivolumab was of no benefit. This case highlights good response to vinblastine which is previously reported to have good success. No trials are published, and the optimal strategy has yet to be defined. LCH with multiple bony involvement can be aggressive and therapeutically challenging.