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Case Reports
. 2023 Jun:107:108351.
doi: 10.1016/j.ijscr.2023.108351. Epub 2023 May 24.

Spinal Langerhans cell histiocytosis with cord compression and neurological deficits: A case report

Mohammed Maan Al-Salihi  1 , Ahmed Saleh  2 , Muath Hussein  3 , Alaaeldin Ahmed  4 , Md Moshiur Rahman  5 , Abdulnasser Alyafai  6
Affiliations
Case Reports

Spinal Langerhans cell histiocytosis with cord compression and neurological deficits: A case report

Mohammed Maan Al-Salihi et al. Int J Surg Case Rep. 2023 Jun.

Abstract

Introduction and importance: Langerhans cell histiocytosis (LCH) is a rare idiopathic disease that uncommonly affect the spine in adults.

Case presentation: In this report, we presented a rare adult case of symptomatic spinal LCH with asymptomatic systemic involvement. She was a 46-year-old previously healthy lady who presented with subacute thoracic sensory level, urine retention, constipation, and pyramidal paraplegia. Her magnetic resonance imaging (MRI) of the spine revealed T6 compression fracture with an epidural mass compressing the cord.

Clinical discussion: Sellar MRI showed pituitary gland enlargement with hyperintense signal in the posterior lobe. Positron emission tomography (PET)/computed tomography (CT) scan showed an increased uptake in the right parotid gland uptake and renal cortex, indicating systemic involvement.

Conclusion: Surgical excision, decompression, and screw fixation were performed, and the patient improved. The prognosis is usually good in patients with solitary spinal LCH.

Keywords: Histiocytosis; Langerhans cell histiocytosis; Spinal cord.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
MRI spine of the patient showing a pathological compression fracture and a paravertebral, paravertebral, and retro-vertebral intraspinal mass that is hyperintense on T2 STIR sequence (d) and hypointense on T1 sequence (a), T2 sequence (b), and T2 TSE sequences.
Fig. 2
Fig. 2
MRI sellar lesion showing pituitary mass with heterogenous signal at T1 sequence with post-contrast enhancement.
See this image and copyright information in PMC

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