Unifocal Langerhans Cell Histiocytosis Presenting as an Aggressive Bone Lesion

Abstract 

Objective

To discuss a case of unifocal Langerhans cell histiocytosis (eosinophilic granuloma) presenting as an aggressive osseous destructive process.

Clinical Features

A 6-year-old girl had thigh pain of insidious onset that would wake her at night. Orthopedic testing reproduced local pain, and imaging revealed an osteolytic process in the femoral diaphysis with laminated periosteal reaction.

Intervention and Outcome

The patient was referred for further evaluation; unifocal Langerhans cell histiocytosis was found at biopsy and spontaneous healing subsequently reported.

Conclusions

Unifocal Langerhans cell histiocytosis may present with deceptive clinical and imaging findings, of which clinicians should be aware.