Langerhans cell histiocytosis of the rib presenting with pathological fracture: a case report

Tao Zuo,Baojun Chen,Ping Jiang,Yong Liu,Junjie Yu,Ke Zhao

doi:10.1186/s13019-020-01368-9

Abstract

IntroductionLangerhans cell histiocytosis (LCH) is a rare neoplastic hyperplasia with an unknown etiology. It is clinically rare for patients with solitary rib lesion and pathological fracture; moreover, its diagnosis and treatment are quite difficult. The purpose of this study is to present a case for the pathogenesis, clinical features, imaging, and treatment of this disease.Case presentationA 52-year-old female patient complained of left chest pain for one week. CT showed a fracture in the left 5th rib. The rib tumor was then resected and the surrounding muscles and soft tissues were accordingly resected. The patient was diagnosed with pathological rib fracture, and the patient was pathologically diagnosed with LCH. After surgery, no local recurrence or distant metastasis was reported during the two-year follow-up.ConclusionsLCH should be treated by observation, chemotherapy, radiotherapy, or surgery, or using a combination of several methods. Moreover, primary tumor should be considered when rib fracture without trauma and tumor metastasis.

Highlights

Langerhans cell histiocytosis (LCH) is a rare neoplastic hyperplasia with an unknown etiology
LCH should be treated by observation, chemotherapy, radiotherapy, or surgery, or using a combination of several methods
LCH has a highly variable clinical presentation, ranging from a single lesion to potentially fatal disseminated disease. It is clinically rare for patients with solitary rib lesion and pathological fracture, and its diagnosis and treatment are

Summary

Introduction

Langerhans cell histiocytosis (LCH) is a rare neoplastic hyperplasia with an unknown etiology. It is clinically rare for patients with solitary rib lesion and pathological fracture; its diagnosis and treatment are quite difficult. LCH has a highly variable clinical presentation, ranging from a single lesion to potentially fatal disseminated disease It is clinically rare for patients with solitary rib lesion and pathological fracture, and its diagnosis and treatment are. Chest computed tomography (CT) conducted at the outpatient department indicated local bone density reduction along with fracture of the left 5th rib and thickening of the soft tissue adjacent to the chest wall; the possibility of a pathological fracture could not be excluded (Fig. 1a). No abnormalities were revealed on the head magnetic resonance imaging (MRI) or color doppler ultrasound of

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