Langerhans cell histiocytosis of atlantoaxial joint in a middle-aged man presenting with deafness as first symptom and soft-tissue mass at neck showing excellent response to radiotherapy alone: Report of an extremely rare and unusual clinical condition and review of literature

• Published in: Annals of the Indian Academy of Neurology Vol. 17; no. 4; pp. 429 - 432
• Main Authors: Mondal, Dodul, Julka, P K, Jana, Manisha, Walia, Ritika, Chaudhuri, Tamojit
• Format: Journal Article
• Language: English
• Published: India Medknow Publications and Media Pvt. Ltd 01-10-2014; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Atlanto-axial joint; Care and treatment; Case Report; Case studies; Complications and side effects; Deafness; Diagnosis; Langerhans cell histiocytosis; male; Mastoid process; Neurological disorders; Radiation therapy; radiotherapy; India; Atlanto-axial joint; radiotherapy; deafness; Langerhans cell histiocytosis; male
• ISSN: 0972-2327; 1998-3549
• DOI: 10.4103/0972-2327.144022

Langerhans cell histiocytosis (LCH) is a disorder of clonal proliferation of dendritic cell mainly occurring in children. Spine involvement is rare. This usually presents with pain and torticollis when neck is involved. Histopathology with immunohistochemistry is confirmatory. Local curative therapy with excision or curettage is used for localized disease. Radiotherapy is usually reserved for selected cases. Systemic chemotherapy is the treatment of choice for widespread systemic disease. In this article, we present an unusual presentation of atlantoaxial LCH with mastoid involvement resulting in hearing loss as the first symptom and quadruparesis in a middle aged male patient, which was also associated with soft-tissue mass at the nape of the neck and deafness. The patient was treated with radical radiotherapy, which provided excellent response to the disease. Involvement of atlantoaxial joint and temporal bone associated with soft-tissue mass neck and deafness in a middle-aged man is an extremely rare clinical situation.