A Case of Langerhans Histiocytosis of the Cervical Spine Successfully Treated with One-stage Local Steroid Injection

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  • Matsuo Mamoru
    Department of Neurosurgery, Nagoya University, Graduate School of Medicine Department of Neurosurgery, Inazawa Municipal Hospital
  • Yamamoto Yu
    Department of Neurosurgery, Inazawa Municipal Hospital
  • Akahori Sho
    Department of Neurosurgery, Nagoya University, Graduate School of Medicine
  • Ito Hiroshi
    Department of Neurosurgery, Inazawa Municipal Hospital
  • Nishimura Yusuke
    Department of Neurosurgery, Nagoya University, Graduate School of Medicine
  • Hara Masahito
    Departmetnt of Spine Center, Aichi Medical University
  • Wakabayashi Toshihiko
    Department of Neurosurgery, Nagoya University, Graduate School of Medicine
  • Takayasu Masakazu
    Department of Neurosurgery, Inazawa Municipal Hospital

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Other Title
  • ステロイド局所注射が奏効した頚椎ランゲルハンス組織球症の1例

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Abstract

<p>  An 11-year-old boy presented to our hospital with neck pain. There were no abnormal findings during the neurological examination or on the cervical radiograph. Therefore, conservative treatment was administered. One month later, the neck pain did not improve, and a hyper-intense lesion was shown at the left side of the C4 vertebral body on T2-weighted magnetic resonance imaging (MRI). An osteolytic lesion was revealed at the same area on computed tomography (CT) scans. There were no abnormalities regarding the laboratory blood tests. The whole-body bone scintigraphy did not reveal other lesions except for the C4 lesion. Clinically, single-organ type, single bone Langerhans cell histiocytosis (LCH) was suspected. An incisional biopsy was performed to rule out the possibility of malignant tumors under CT-guided navigation (O-arm). Because rapid pathological diagnosis during surgery excluded the possibility of osteomyelitis, local steroid injection was administered at the same site. The final pathological diagnosis was LCH. The osteolytic lesion disappeared postoperatively. There are several reports on local steroid injections after a definitive diagnosis of LCH. We performed the biopsy and local steroid injection simultaneously to lessen the burden on the patient and increase the accuracy of steroid injection after excluding the possibility of inflammatory diseases, and had excellent results.</p>

Journal

  • Spinal Surgery

    Spinal Surgery 35 (2), 175-180, 2021

    The Japanese Society of Spinal Surgery

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