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3 year old boy with. 3 swelling over the scalp , biopsy of which is proved as langerhans cell histiocytosis. involement of lt optic nerve with loss of vision in that eye also has diabetes insipidus LFT- normal BOnemarrow_normal study peripheral smear- normal study except for iron deficiency anemia. when is chemotheraphy indicated, is their need to emergency radiotheraphy to orbit
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After complete evaluation, patients with disease involving a single bone and, in some instances, patients with disease involving multiple lesions and multiple bones are managed with local therapy. This involves surgical curettage for patients whose lesions are in easily accessible, noncritical locations. Localized radiotherapy using megavoltage equipment is usually given to patients at risk for skeletal deformity, visual loss secondary to exophthalmos. Low-risk patients > 2 yr old with single-system disease, either in a single bone or multiple bones, frequently require local therapy and little if any systemic therapy. However, failure to thrive or a persistently elevated ESR may indicate significant systemic disease.
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