Presentation
Limp
Patient Data
Age: 4 years
Gender: Female
From the case:
Langerhans cell histiocytosis
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Ill-defined lucency within the femoral shaft with surrounding layering periosteal reaction. The differential includes LCH and Ewing sarcoma (the latter being less likely because of age).
From the case:
Langerhans cell histiocytosis
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Solitary lesion on the imaging provided. Mid-shaft femoral bone edema with surrounding periosteal reaction and soft-tissue edema. No associated mass.
Case Discussion
The diagnosis was between Langerhans cell histiocytosis (LCH) and Ewing sarcoma. Ewing sarcoma would be unusual in a child under 5 and biopsy confirmed LCH as the diagnosis.
Skeletal survey was performed to identify any additional lesions: there were none. This is solitary, single system LCH.
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