Multisystemic recurrent Langerhans cell histiocytosis misdiagnosed with chronic inflammation at the first diagnosis: A case report

Table 1 Timeline of patient’s course of illness

Date	Symptoms onset	Imaging examination	Treatments administered	Follow-up outcomes
June 5, 2016	Dry mouth, polydipsia, polyuria for 4 yr and fatigue for 10 d	Cranial CT scan, cranial MRI enhancement scan	Right frontotemporal craniotomy for tumor removal	Onset of bilateral visual impairment
July 22, 2016	Poor glycemic control, nausea, and vomiting for 1 d	None	Received treatment to stabilize blood sugar levels	Discharge after blood sugar stabilized
February 28, 2017	Pain in the right hip, right thigh, and right knee for more than 6 months, which was aggravated by walking	X-ray examination of the bilateral hip and right lower limb, three-dimensional CT examination of both lower limbs	Excision of the right femoral mass	Discharge after operation
July 19, 2017	Pain in both ears with pus, pain in the right orbital region, skin pain on the head, and multiple rashes all over the body	Orbital CT and MRI	Multiple chemotherapy sessions over 7 months	Patient condition gradually worsened, and culminated with death at home

CT: Computed tomography; MRI: Magnetic resonance imaging.