Palliative radiotherapy in a patient with Erdheim-Chester disease

Erdheim-Chester disease (ECD) is a rare type of non-Langerhans cell histiocytosis, which is reported in less than a thousand cases. Although palliative radiotherapy is the principal treatment of patients with painful bone metastasis, there is very limited evidence for the efficacy of palliative radiotherapy for ECD. A 50-year-old female patient with ECD was referred to our department with a complaint of back pain and numbness in the lower limbs owing to spinal cord compression. She underwent several courses of palliative radiation therapy, some of which resulted in a marked response. She was treated with palliative radiotherapy of 30 Gy in 10 fractions for the knee. Almost complete disappearance of the pain was achieved after radiation therapy. Radiotherapy comprising 20 Gy in five fractions was performed for spinal cord compression in the upper thoracic spine. Post-treatment magnetic resonance imaging showed marked improvement in spinal compression. The present case report represented the effect of radiotherapy on bone lesions associated with ECD. Further research on radiotherapy for ECD should be conducted in the future.