EOSINOPHILIC GRANULOMA OF FEMUR WITH PATHOLOGICAL FRACTURE - A CASE REPORT

Abstract

Abstract : Introduction- Langerhans cell histiocytosis of bone (eosinophilic granuloma) is a benign neoplasm characterized by localized proliferation of predominantly eosinophils               andhistiocytes. A high index of suspicion is required for              making an early diagnosis and initiating appropriate                  treatment1. Different forms of treatment have been reported to give satisfactory results. we report a case of eosinophilic granuloma of femur in a 30 year male presenting with               pathological fracture.Case presentation A 30 year male            patient presented with pain over right thigh withhistory of trivial fall and fracture of shaft of femur. He had pain in his right thigh for 6 months duration. On investigating , X ray showed osteolytic lesions and periosteal reaction with              pathological fracture in proximal metaphysis and diaphyseal region. He was treated withopen biopsy and external fixation. Biopsy revealed langerhan cell histiocytosis of femur for which he was treated with Radiotherapy. External fixator was removed , later Interlocking nailing was done. Post operatively he was given a second cycle of radiotherapy.Conclusion  Patient symptomatically improved after the initiation of               treatment. LCH is an uncommon disease and presenting with pathological fracture is a rarity. Literature search revealed no case has been reported so far with this kind of presentation.

Keyword : langerhanscell histiocytosis, eosinophilic                granuloma, osteolytic lesion, nailing