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Recurrent torticollis secondary to Langerhans cell histiocytosis: a case report
Stavroula Kostaridou1, John Anastasopoulos, Charalambos Veliotis
1Haematology/Oncology Unit, 1st Department of Paediatrics/ University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece.
Insights
Langerhans Cell Histiocytosis (LCH) can cause recurrent torticollis in children. Early diagnosis is crucial to prevent complications, as this rare condition may be overlooked.
Area of Science:
- Pediatric Orthopedics
- Pediatric Oncology
- Pediatric Rheumatology
Background:
- Torticollis is a common pediatric sign with diverse causes.
- Langerhans Cell Histiocytosis (LCH) is a rare disorder affecting multiple organ systems.
Observation:
- A 1-year-old boy presented with recurrent torticollis and a temporal bone swelling.
- Initial diagnosis was delayed due to the rarity of LCH as a cause of torticollis.
Findings:
- Langerhans Cell Histiocytosis (LCH) was confirmed via biopsy of a calvarial lesion.
- The patient achieved complete remission after 52 weeks of chemotherapy (steroids and etoposide).
Implications:
- Highlights the importance of considering rare diagnoses like LCH in pediatric torticollis.
- Emphasizes early diagnosis to prevent neurological damage and long-term complications.
- Suggests LCH should be included in the differential diagnosis for persistent pediatric torticollis.
Abstract:
Torticollis is a common clinical sign encountered by pediatricians and orthopaedic surgeons in a wide spectrum of childhood conditions ranging from benign to life-threatening. We report the case of a child with recurrent torticollis caused by Langerhans Cell Histiocytosis (LCH). The patient was a 1-year-old boy with recurrent torticollis, followed by a painless swelling over the right temporal bone. The diagnosis was confirmed by an open biopsy of the calvarial lesion. As LCH is a very rare cause of torticollis it was not considered in the initial differential by the primary care physicians and the diagnosis was delayed about 4 months. The patient received chemotherapy with steroids and etoposide for 52 weeks. He showed complete regression of the sign and imaging tests at the end of treatment were normal. No relapse of symptoms occurred during a follow-up period of 2 years. The rarity of this disease as well as the site and form of presentation are emphasised to alert physicians for an early diagnostic evaluation, which is important to prevent neurological lesions and other late complications.