Article Text

Download PDFPDF
Case report
Langerhans cell histiocytosis in the occipital condyle: a case study and a brief review of the literature
  1. Nuno Cesar Barbosa1,
  2. Acacio Ramos1,2,
  3. Amets Sagarribay3 and
  4. Maria José Ribeiro4
  1. 1Ortopedia, Hospital of Vila Franca de Xira, Vila Franca de Xira, Portugal
  2. 2Ortopedia, Hospital Particular do Algarve, Gambelas, Portugal
  3. 3Neurocirurgia, Hospital Dona Estefania, Lisboa, Portugal
  4. 4Oncologia Pediátrica, Instituto Português de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal
  1. Correspondence to Dr Nuno Cesar Barbosa; nuno.barbosa{at}


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.

  • chemotherapy
  • paediatric oncology
  • orthopaedics
  • neurosurgery

Statistics from


  • Contributors NCB drafted the manuscript, acquisited and analysed data and designed the figures. AR was involved in conception, planning and supervised the work, and revised critically fo important intellectual content. AS and MJR were involved in acquisition of data and analysis and interpretation of data. AR, AS and MJR were involved in patient’s care. All authors were involved in the final approval of the version published. NCB agreed to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.