Langerhans Cell Histiocytosis Masquerading as a Benign Tumor in Femoral Neck—Managed with a Distinctive Technique: A Case Report
Year: 2026
Type: article
Study design: Case Report
Abstract: due to an indistinguishable radiological finding; this was treated with a novel method of biological fixation of lesions in the neck of the femur with autologous fibular strut graft and cancellous bone graft. Case DesCriptionA 17-year-old female presented to our outpatient department with complaints of pain in her right hip for 8 months, which was insidious in onset, gradually progressive, increased at night, and also increased with squatting and running, and relieved with analgesics.Initially, the patient had been taking analgesics for 5 months, but the pain was present on and off and started to restrict the patient's activities, mainly squatting and sitting cross-legged.introDuCtion Histiocytosis X was described by Lichtenstein as a term to elucidate various reticulosis because of an unknown etiology.1 Eosinophilic granuloma (EG) is the localized form, Letterer-Siwe's disease is the acute form, and Hand-Schüller-Christian disease is the chronic form, grouped due to similar pathological features.2 The disease can affect virtually any body organ system, thus having a wide range of clinical presentations.The most prevalent histiocytic condition, Langerhans cell histiocytosis (LCH), is characterized by the accumulation of langerinpositive cells as granulomatous lesions that spread throughout the body as inflammatory infiltrates in different tissues.3 The most common involvement is of the axial skeleton: spine, skull, and pelvis.In long bones, the most common bone is the femur, followed by the humerus and tibia.The lesion can involve the metaphysis but rarely crosses the physis.4 Radiologically, the lesion can have a varied appearance, most commonly marked flattening of vertebral bodies or vertebral plana.Flat bones can show "punched out" or "bone-within-bone appearance."The diaphysis of long bones can show a permeative appearance with a periosteal reaction, confusing the diagnosis with Ewing's sarcoma, lymphoma, or infection.5 Radiographs have continued to remain the gold standard for diagnosis.Magnetic resonance imaging (MRI) and computed tomography (CT) scans show nonspecific marrow edema and a "budding appearance."However, they can help find out the true extent of the soft tissue of the lesion before biopsy or surgical intervention.Once the clinicians reach a definitive diagnosis, treatment for the disease is tailored for every patient.The neck of the femur is an unusual presentation site for an EG and can be easily confused with an alternative diagnosis due to a lack of suspicion.We describe a rare case that presented with persistent symptoms on treatment, an atypical radiological site and appearance, which was misdiagnosed on biopsy
Authors: Deepak Kumar, Mandeep Singh Dhillon, Pulak Vatsya, Harsh Mander, Aman Hooda
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7130519890