New study reveals surgery may be avoided for children with rare skull tumor

In a recent study, a team of experts found that youngsters with a rare skull tumour instance can forego surgery.

Researchers from Cornell Medicine, NewYork-Presbyterian, Nicklaus Children’s Hospital, University of Texas Southwestern, University of British Columbia, and McGovern Medical School conducted the study. The New England Journal of Medicine reported the study’s findings.

A series of diseases known as Langerhans-cell histiocytosis (LCH) are characterised by immune cells called Langerhans cells that overproliferate and damage or create lesions in the tissue.

Children appear with a painful skull mass when this, also known as solitary eosinophilic granuloma, affects the skull in an isolated manner. Neurosurgeons typically treat these tumours or lumps, which are not cancerous. Historically, these tumours have been removed surgically, and the affected area of the skull has been rebuilt. A multicenter prospective research was started because certain retrospective case studies suggested that these lesions could go away without surgery. The findings, which were detailed in a letter to the editor that was published in the New England Journal of Medicine on June 30, indicated that the lesions spontaneously resolved in 88 percent of the individuals who were monitored.

28 kids with LCH were enrolled in the trial between September 2012 and January 2020 at eight hospitals by the researchers. The researchers decided that, as a precaution, patients in this group would be given surgery if their lesions expanded quickly or for more than two months, didn’t diminish within three months, or caused discomfort. While 11 children and their parents opted for surgical or other procedures, 17 patients and their parents preferred to take part in the study’s observation-only group. All 17 lesions in the observation-only group shrank or vanished after two months. According to the authors, 15 out of 17 patients had totally recovered from their lesions after a year.

Of the 11 patients who chose treatment, ten got surgery to remove their lesions, two received chemotherapy to help the lesions shrink, one had a glucocorticoid injection inside the lesion, and six underwent a second operation to fix the skull defect caused by the mass or surgery. According to the authors, after roughly two months had passed and the lesion on one kid who had initially been in the observation group had decreased but not entirely vanished, the child’s parents changed their minds and decided to have surgery.

For isolated LCH skull lesions, this pioneering prospective research supports a nonsurgical treatment strategy. The benefit of this strategy is that it avoids surgery and all related dangers with removal.