E-ISSN: 1019-5157
ISSN: 2651-5024
Case Report
Langerhans Cell Histiocytosis with Cervical Spine Involvement: A Rare Case and Review of the Literature
Sezer Onur GÜNARA✉ ,
Serkan BÜTÜN ,
Abdurrahman ARPA ,
Tevfik YILMAZ
DOI: 10.5137/1019-5149.JTN.50192-25.3
Article in Press
Corresponding Author:
Sezer Onur GÜNARA (sezeronurgunara21@gmail.com)
Abstract
Introduction:
Langerhans cell histiocytosis is a rare systemic disorder, and spinal involvement is exceptionally uncommon. This study aims to report a rare case of Langerhans cell histiocytosis affecting the cervical spine and to discuss the condition in the context of the existing literature.
Case Report:
A 19-year-old male was admitted to our department with persistent neck pain, weakness in the right upper limb, episodic fever, and general malaise. The patient had previously been treated with appropriate analgesic and anti-inflammatory medications; however, his symptoms failed to resolve, prompting referral to our clinic. On clinical assessment, cervical movements were painful, and motor weakness was noted in the right upper limb and shoulder (motor strength of right upper-extremity elbow flexion and extension was graded MRC 34/5). Imaging studies demonstrated pathological involvement of the C4 vertebral body, its posterior components, and the anterior epidural region. Computed tomography (CT) demonstrated lytic lesions of the C4 vertebral body, while magnetic resonance imaging (MRI) revealed hyperintense signals involving the C4 vertebral body, posterior elements, and the anterior epidural space on both T1- and T2-weighted sequences. The patient underwent a C4 corpectomy followed by fusion using an autograft. Histopathological examination of the resected specimen confirmed the diagnosis of Langerhans cell histiocytosis. During postoperative follow-up, the patient remained asymptomatic for 6 months.
Conclusion:
Although Langerhans cell histiocytosis is rare, it should be considered in the differential diagnosis of cervical and other spinal lesions. Surgery should be considered for patients with persistent, treatment-resistant pain that significantly affects quality of life, or in cases where neurological impairment is clinically evident.
Langerhans cell histiocytosis is a rare systemic disorder, and spinal involvement is exceptionally uncommon. This study aims to report a rare case of Langerhans cell histiocytosis affecting the cervical spine and to discuss the condition in the context of the existing literature.
Case Report:
A 19-year-old male was admitted to our department with persistent neck pain, weakness in the right upper limb, episodic fever, and general malaise. The patient had previously been treated with appropriate analgesic and anti-inflammatory medications; however, his symptoms failed to resolve, prompting referral to our clinic. On clinical assessment, cervical movements were painful, and motor weakness was noted in the right upper limb and shoulder (motor strength of right upper-extremity elbow flexion and extension was graded MRC 34/5). Imaging studies demonstrated pathological involvement of the C4 vertebral body, its posterior components, and the anterior epidural region. Computed tomography (CT) demonstrated lytic lesions of the C4 vertebral body, while magnetic resonance imaging (MRI) revealed hyperintense signals involving the C4 vertebral body, posterior elements, and the anterior epidural space on both T1- and T2-weighted sequences. The patient underwent a C4 corpectomy followed by fusion using an autograft. Histopathological examination of the resected specimen confirmed the diagnosis of Langerhans cell histiocytosis. During postoperative follow-up, the patient remained asymptomatic for 6 months.
Conclusion:
Although Langerhans cell histiocytosis is rare, it should be considered in the differential diagnosis of cervical and other spinal lesions. Surgery should be considered for patients with persistent, treatment-resistant pain that significantly affects quality of life, or in cases where neurological impairment is clinically evident.
Keywords
Langerhans cell histiocytosis
cervical spine
corpectomy
autograft