Langerhans cell histiocytosis in the occipital condyle: a case study and a brief review of the literature

BMJ Case Rep. 2020 Dec 12;13(12):e235630. doi: 10.1136/bcr-2020-235630.

Abstract

We present a case study of a 5-year-old patient, who presented with left-sided torticollis. Due to persistence of problems, a CT and an MRI were made showing a single osteolytic lesion centred on right occipital condyle. After an open biopsy, histology confirmed it to be Langerhans cell histiocytosis (LCH). Torticollis or restricted range of motion is a presenting feature in 76% of children with LCH with cervical involvement. There remains much debate on the best treatment strategy. The clinical and radiological outcomes of the case study presented on this article support the treatment of LCH with chemotherapy in cases with solitary involvement of the occipital condyle.

Keywords: chemotherapy; neurosurgery; orthopaedics; paediatric oncology.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Child, Preschool
  • Female
  • Histiocytosis, Langerhans-Cell / complications
  • Histiocytosis, Langerhans-Cell / diagnosis*
  • Histiocytosis, Langerhans-Cell / surgery
  • Humans
  • Magnetic Resonance Imaging
  • Neck Pain / etiology
  • Occipital Bone / diagnostic imaging
  • Occipital Bone / pathology*
  • Occipital Bone / surgery
  • Radionuclide Imaging
  • Tomography, X-Ray Computed
  • Torticollis / etiology