A Challenging Case of Neurodegenerative type of Central Nervous System
Langerhans Cell Histiocytosis
Abstract
Neurodegenerative (ND) type of Central Nervous System (CNS) Langerhans
Cell Histiocytosis (LCH) is a very rare disease. We report a case of a
pregnant teenager found to have central diabetes insipidus and T2 FLAIR
contrast-enhancing lesions on MRI brain. Extensive workup including
brain biopsy showed inflammation and concern for LCH. Progressive
neurological symptoms prompted the start of low-dose cytosine
arabinoside chemotherapy. Her symptoms and serial MRI brain scans showed
a complete tumor response to the chemotherapy. Off-therapy tumor
recurrence prompted the use of MAPK (mitogen-activated protein kinase)
pathway agent Trametinib with good response.