A 2-year-boy was presented with a 1-year history of refractory eczema and enlarging neck masses for the last 4 weeks. Examination His weight and height were below the fifth percentile for his age. Bilateral proptosis and serous discharge from both ears and extensive rash on the scalp, chest, and upper back were noted. There were palpable defects in the skull and bilateral posterior cervical, submandibular, and supraclavicular lymphadenopathy. No signs of hepatosplenomegaly or diabetes were observed.
Chronic anemia with Hb level of 6.6g/dL with normal WBC and platelet counts were noted. A skeletal examination revealed multiple lytic lesions in the skull and soft-tissue masses were noted. What is the diagnosis and treatment? *This case is from Docplexus editorial team for educative purpose only. Source: NEJM Stay Connected, the answer will be posted within next 48h!
