{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:05:46Z","timestamp":1760058346791,"version":"build-2065373602"},"reference-count":38,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T00:00:00Z","timestamp":1742860800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Rosai\u2013Dorfman disease (RDD) is a rare proliferative disorder characterized by an overproduction of a type of immune cell called histiocytes, with unknown etiology. Although extranodal involvement is not uncommon, it is rarely seen within the nose. The available data are limited, and currently, there are no established guidelines for managing RDD. Different therapeutic options have been described, including corticosteroids, surgery, radiotherapy, or chemotherapy. This study aims to evaluate the potential benefit of radiotherapy in patients with nasal Rosai\u2013Dorfman disease to improve the current diagnostic and therapeutic management. Herein, we report the case of a 54-year-old female patient with nasal RDD refractory to systemic corticosteroid therapy and transnasal endoscopic resection. She received fractionated low-dose radiotherapy with a total dose of 30 cGy administered in 2 cGy daily fractions. Complete remission was achieved, highlighting the potential role of radiotherapy as an effective therapeutic option for relapsing or steroid-refractory cases. This is one of the few well-documented cases reported with nasal Rosai\u2013Dorfman disease treated with radiotherapy. Ongoing research on novel therapies offers hope for improved outcomes in relapsing cases that fail to respond to conventional treatments.<\/jats:p>","DOI":"10.3390\/medicina61040585","type":"journal-article","created":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T10:48:58Z","timestamp":1742899738000},"page":"585","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of Radiotherapy in Patients with Relapsing Primary Rosai\u2013Dorfman Disease of the Nasal Cavity"],"prefix":"10.3390","volume":"61","author":[{"given":"Caius-Codrut","family":"Sarafoleanu","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Otorhinolaryngology, \u201cSfanta Maria\u201d Clinical Hospital, 011172 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0296-8141","authenticated-orcid":false,"given":"Florentina-Carmen","family":"Badea","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Medicover Hospital, 020331 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alina-Maria","family":"Georgescu","sequence":"additional","affiliation":[{"name":"Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"},{"name":"Department of Laboratory Medicine, Victor Babes Clinical Hospital of Infectious Diseases and Pneumophthisiology, 200515 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6731-3341","authenticated-orcid":false,"given":"Gabriela-Cornelia","family":"Musat","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Otorhinolaryngology, \u201cSfanta Maria\u201d Clinical Hospital, 011172 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anica","family":"Andrei","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, Radiation Therapy Center Amethyst, 075100 Otopeni, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ionut","family":"Tanase","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Otorhinolaryngology, \u201cSfanta Maria\u201d Clinical Hospital, 011172 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,25]]},"reference":[{"key":"ref_1","first-page":"1169","article-title":"Adenitis with lipid excess, in children or young adults, seen in the Antilles and mali (4 cases)","volume":"58","author":"Destombes","year":"1965","journal-title":"Bull. Soc. Pathol. Exot. Fil."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1002\/1097-0142(197211)30:5<1174::AID-CNCR2820300507>3.0.CO;2-S","article-title":"Sinus histiocytosis with massive lymphadenopathy: A pseudolymphomatous benign disorder. Analysis of 34 cases","volume":"30","author":"Rosai","year":"1972","journal-title":"Cancer"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2672","DOI":"10.1182\/blood-2016-01-690636","article-title":"Revised classification of histiocytoses and neoplasms of the macrophage-dendritic cell lineages","volume":"127","author":"Emile","year":"2016","journal-title":"Blood"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.1002\/1097-0142(19841101)54:9<1834::AID-CNCR2820540911>3.0.CO;2-F","article-title":"Sinus Histiocytosis with Massive Lymphadenopathy An Analysis of 14 Deaths Occurring in a Patient Registry","volume":"54","author":"Foucar","year":"1984","journal-title":"Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2877","DOI":"10.1182\/blood-2018-03-839753","article-title":"Consensus recommendations for the diagnosis and clinical management of Rosai-Dorfman-Destombes disease","volume":"131","author":"Abla","year":"2018","journal-title":"Blood"},{"key":"ref_6","first-page":"304","article-title":"Intracranial Rosai-Dorfman disease","volume":"17","author":"Mahzoni","year":"2012","journal-title":"J. Res. Med. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1007\/s00405-022-07646-7","article-title":"Clinical features, diagnosis, treatment and prognosis of otolaryngological extranodal sinus histiocytosis with massive lymphadenopathy (Rosai\u2013Dorfman disease, RDD)","volume":"280","author":"Li","year":"2023","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Wu, K.J., Li, S.H., Liao, J.B., Chiou, C.C., Wu, C.S., and Chen, C.C. (2021). NRAS mutations may be involved in the pathogenesis of cutaneous rossi dorfman disease: A pilot study. Biology, 10.","DOI":"10.3390\/biology10050396"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1002\/ana.25281","article-title":"BRAF mutation leading to central nervous system rosai-dorfman disease","volume":"84","author":"Richardson","year":"2018","journal-title":"Ann. Neurol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1038\/modpathol.2017.55","article-title":"Mutually exclusive recurrent KRAS and MAP2K1 mutations in Rosai-Dorfman disease","volume":"30","author":"Garces","year":"2017","journal-title":"Mod. Pathol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Morgan, N.V., Morris, M.R., Cangul, H., Gleeson, D., Straatman-Iwanowska, A., Davies, N., Keenan, S., Pasha, S., Rahman, F., and Gentle, D. (2010). Mutations in SLC29a3, encoding an equilibrative nucleoside transporter ENT3, cause a familial histiocytosis syndrome (Faisalabad histiocytosis) and familial Rosai-Dorfman disease. PLoS Genet., 6.","DOI":"10.1371\/journal.pgen.1000833"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"364","DOI":"10.3324\/haematol.2015.138081","article-title":"Bone marrow findings in autoimmune lymphoproliferative syndrome with germline FAS mutation","volume":"102","author":"Xie","year":"2017","journal-title":"Haematologica"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1111\/his.12274","article-title":"A subset of Rosai-Dorfman disease cases show increased IgG4-positive plasma cells: Another red herring or a true association with IgG4-related disease?","volume":"64","author":"Menon","year":"2014","journal-title":"Histopathology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.clim.2016.12.006","article-title":"The importance of considering monogenic causes of autoimmunity: A somatic mutation in KRAS causing pediatric Rosai-Dorfman syndrome and systemic lupus erythematosus","volume":"175","author":"Ragotte","year":"2017","journal-title":"Clin. Immunol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1038\/modpathol.3880071","article-title":"Sinus Histiocytosis with Massive Lymphadenopathy and Malignant Lymphoma Involving the Same Lymph Node: A Report of Four Cases and Review of the Literature","volume":"13","author":"Lu","year":"2000","journal-title":"Mod. Pathol."},{"key":"ref_16","first-page":"232898","article-title":"Rosai-Dorfman Disease Originating from Nasal Septal Mucosa","volume":"2015","author":"Akyigit","year":"2015","journal-title":"Case Rep. Otolaryngol."},{"key":"ref_17","first-page":"13532","article-title":"Case Report Rosai-Dorfman disease (RDD) in the paraglottic space: Report of a case and review of literature","volume":"8","author":"Ma","year":"2015","journal-title":"Int. J. Clin. Exp. Pathol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/0046-8177(93)90160-I","article-title":"Extranodal Sinus Histiocytosis with Massive Lymphadenopathy (Rosai-Dorfman Disease) of the Head and Neck","volume":"24","author":"Wenig","year":"1993","journal-title":"Hum. Pathol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e158","DOI":"10.3747\/co.v18i3.761","article-title":"Radiotherapy for steroid-resistant laryngeal Rosai-Dorfman disease","volume":"18","author":"Toguri","year":"2011","journal-title":"Curr. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1177\/019459989010200624","article-title":"Extranodal head and neck sinus histiocytosis with massive lymphadenopathy","volume":"102","author":"Naidu","year":"1990","journal-title":"Otolaryngol. Head. Neck Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"NP604","DOI":"10.1177\/01455613221079500","article-title":"Rosai-Dorfman disease originating from nasal septal mucosa and presenting with nasal dorsum collapse: A case report with literature review","volume":"103","author":"Wang","year":"2024","journal-title":"Ear Nose Throat J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1111\/his.14664","article-title":"Limited sinonasal Rosai\u2013Dorfman disease presenting as chronic sinusitis","volume":"81","author":"Rooper","year":"2022","journal-title":"Histopathology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/0046-8177(92)90320-3","article-title":"lmmunophenotypic Characterization of the Cell Infiltrate in Five Cases of Sinus Histiocytosis with Massive Lymphadenopathy (Rosai-Dorfman Disease)","volume":"23","author":"Paulli","year":"1992","journal-title":"Hum. Pathol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1016\/j.radcr.2023.11.055","article-title":"Uncommon presentation of Rosai-Dorfman disease: Nasal and nasopharyngeal involvement: A case report and discussion","volume":"19","author":"Dhakal","year":"2024","journal-title":"Radiol. Case Rep."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1080\/00016480500452582","article-title":"Extranodal Rosai-Dorfman disease: Involvement of eye, nose and trachea","volume":"126","author":"Ottaviano","year":"2006","journal-title":"Acta Otolaryngol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1038\/s41572-021-00307-9","article-title":"Histiocytic disorders","volume":"7","author":"McClain","year":"2021","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1017\/S0022215100143786","article-title":"Nasal manifestation of extranodal Rosai-Dorfman disease-diagnosis and management","volume":"113","author":"Ku","year":"1999","journal-title":"J. Laryngol. Otol."},{"key":"ref_28","first-page":"19","article-title":"Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease): Review of the entity","volume":"7","author":"Foucar","year":"1990","journal-title":"Semin. Diagn. Pathol."},{"key":"ref_29","first-page":"6","article-title":"The treatment of sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease)","volume":"7","author":"Komp","year":"1990","journal-title":"Semin. Diagn. Pathol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1002\/(SICI)1096-911X(199609)27:3<187::AID-MPO10>3.0.CO;2-D","article-title":"Sinus histiocytosis with Massive Lymphadenopathy (Rosai-Dorfman Disease): Response to Methotrexate and Mercaptopurine","volume":"27","author":"Horneff","year":"1996","journal-title":"Med. Pediatr. Oncol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1097\/00005537-199603000-00002","article-title":"Extranodal Rosai-Dorfman Disease of the Head and Neck","volume":"106","author":"Goodnight","year":"1996","journal-title":"Laryngoscope"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"E1","DOI":"10.1002\/ajh.24225","article-title":"Lenalidomide in the treatment of Rosai Dorfman disease-a first in use report","volume":"91","author":"Rubinstein","year":"2016","journal-title":"Am. J. Hematol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2398","DOI":"10.1056\/NEJMc1713676","article-title":"Rosai\u2013Dorfman Disease with Activating KRAS Mutation\u2014Response to Cobimetinib","volume":"377","author":"Jacobsen","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"299","DOI":"10.3329\/jbcps.v40i4.61894","article-title":"Rosai-Dorfman Disease: A Case Report","volume":"40","author":"Halder","year":"2022","journal-title":"J. Bangladesh Coll. Phys. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s13643-021-01581-0","article-title":"Diagnosis and treatment of Rosai-Dorfman disease of the spine: A systematic literature review","volume":"10","author":"Hu","year":"2021","journal-title":"Syst. Rev."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1002\/hed.21832","article-title":"Factors associated with recurrence and therapeutic strategies for sinonasal Rosai-Dorfman disease","volume":"34","author":"Chen","year":"2012","journal-title":"Head Neck"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1007\/s12105-019-01056-8","article-title":"Extranodal Rosai-Dorfman Disease Originating in the Nasal and paranasal Complex and Gnathic Bones: A Systematic Analysis of Seven Cases and Review of Literature","volume":"14","author":"Ojha","year":"2019","journal-title":"Head Neck Pathol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1002\/ajh.10008","article-title":"Treatment of sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease): Report of a case and literature review","volume":"69","author":"Jassal","year":"2002","journal-title":"Am. J. Hematol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/4\/585\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:59:38Z","timestamp":1760029178000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/4\/585"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,25]]},"references-count":38,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["medicina61040585"],"URL":"https:\/\/doi.org\/10.3390\/medicina61040585","relation":{},"ISSN":["1648-9144"],"issn-type":[{"type":"electronic","value":"1648-9144"}],"subject":[],"published":{"date-parts":[[2025,3,25]]}}}