Salvage Gamma Knife Stereotactic Radiosurgery for Recurrent Intracranial Langerhans Cell Histiocytosis: A 36-Year Saga.

Background: Management of intracranial Langerhans cell histiocytosis generally includes surgical resection.

Case Description: A female patient with a diagnosis of Langerhans cell histiocytosis developed multiple brain lesions. As part of her multimodality treatment, she underwent Gamma Knife stereotactic radiosurgery on 4 occasions over a 20-year period. All tumors showed significant shrinkage on serial imaging after initially demonstrating a transient expansion. No permanent postradiosurgery complications occurred.

Conclusions: As part of multimodality management of this recurrent and refractory disease, Gamma Knife stereotactic radiosurgery should be considered an important salvage option that can control local disease and obviate the need for invasive surgery.