Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2017; 5(8): 344-348
Published online Aug 16, 2017. doi: 10.12998/wjcc.v5.i8.344
Atlanto-axial langerhans cell histiocytosis in a child presented as torticollis
Miniar Tfifha, Mehdi Gaha, Nadia Mama, Mohamed Taher Yacoubi, Saoussen Abroug, Hela Jemni
Miniar Tfifha, Saoussen Abroug, Pediatrics Department, Sahloul University Hospital, Sousse 4054, Tunisia
Mehdi Gaha, Nadia Mama, Hela Jemni, Radiology Department, Sahloul University Hospital, Sousse 4054, Tunisia
Mohamed Taher Yacoubi, Pathology Department, Farhat Hached University Hospital, Sousse 4031, Tunisia
Author contributions: Tfifha M, Mama N and Gaha M contributed to project development, data collection, bibliography review, manuscript writing; Yacoubi MT contributed to data collection and bibliography review; Jemni H and Abroug S contributed to data collection and manuscript writing.
Institutional review board statement: This case report was exempt from the Institutional Review Board standards at Sahloul University Hospital Sousse Tunisia.
Informed consent statement: The parents of the patient involved in this study gave their written informed consent authorizing use and disclosure of his protected health information.
Conflict-of-interest statement: All the authors have no conflicts of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Mehdi Gaha, Radiologist, Radiology Department, Sahloul University Hospital, Route de Ceinture, Sousse 4054, Tunisia. gahamehdi@rns.tn
Telephone: +216-73-369411 Fax: +216-73-367451
Received: December 22, 2016
Peer-review started: December 27, 2016
First decision: January 14, 2017
Revised: April 21, 2017
Accepted: May 12, 2017
Article in press: May 15, 2017
Published online: August 16, 2017
Processing time: 236 Days and 13.6 Hours
Abstract

Langerhans cell histiocytosis (LCH) is a rare condition mostly seen in children and adolescents. Eosinophilic granuloma (EG) is one of its three clinical entities and is considered as a benign osteolytic lesion. Many reports of patients with spine histiocytosis are well documented in the literature but it is not the case of atlantoaxial localization. We report here a new observation of atlantoaxial LCH in a 4-year-old boy revealed by persistent torticollis. He was successfully treated with systemic chemotherapy and surgery. Inter-body fusion packed by autologous iliac bone was performed with resolution of his symptoms. It is known that conservative treatment is usually sufficient and surgery should be reserved for major neurologic defects in spine EG. In atlantoaxial lesion, surgical treatment should be frequently considered.

Keywords: Langerhans cell histiocytosis; Eosinophilic granuloma; Torticollis; Cervical spine

Core tip: Langerhans cell histiocytosis (LCH) is a rare condition mostly seen in children and adolescents. Eosinophilic granuloma is one of its three clinical entities and is considered as a benign osteolytic lesion. Many reports of patients with spine histiocytosis are well documented in the literature but it is not the case of atlantoaxial localization. We report here a new observation of atlantoaxial LCH in a 4-year-old boy revealed by persistent torticollis.