Langerhans cell histiocytosis after therapy for a malignant germ cell tumor of the central nervous system

Langerhans cell histiocytosis (LCH) is a clonal neoplastic disorder that re sults in a spectrum of clinical manifestations. Known to be associated with a variety of malignant diseases, LCH may precede, coincide with, or develo p after the diagnosis of cancer. A child with a malignant germ cell tumor o f the brain who subsequently experienced LCH is reported. The 8-year-old bo y was treated for an immature teratoma of the posterior fossa with gross to tal resection and craniospinal irradiation preceding bleomycin, etoposide, and vinblastine chemotherapy for four cycles. Seven months after completion of therapy, he experienced multifocal bone disease with LCH.