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Basilar Invagination Caused by Langerhans Cell Histiocytosis of the Atlas in an AdultA Case Report
ChangRong Zhu, MD1; JianHua Wang, MD1; Ying Zhang, MD1; Hong Xia, MD1; QingShui Yin, MD1
1 Department of Orthopedics, Liu Hua Qiao Hospital, 111 Liu Hua Road, Guangzhou, 510010, China. E-mail address for J. Wang: jianhuawangddrr@163.com
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Investigation performed at the Department of Orthopedics, Liu Hua Qiao Hospital, Guangzhou, China

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2013 Jun 26;3(2):e63 1-5. doi: 10.2106/JBJS.CC.L.00255
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Langerhans cell histiocytosis (LCH) is a rare disease that can affect patients of any age, although most patients present as children between the ages of five and ten years old1,2. The incidence of spine involvement is reported to range between 7% and 25% for patients with osseous LCH2,3. There are very few published cases describing LCH of the atlas, especially in adult patients. To our knowledge, only sixteen pediatric LCH cases that involve the atlas have been reported; the age of onset ranged from age two to seventeen. Only two cases of LCH of the atlas in adults have been reported: one patient was twenty-six years old, and the other patient was thirty-seven years old4,5. To the best of our knowledge, we report the first adult patient with LCH involving the anterior arch of the atlas that led to basilar invagination who was successfully treated with use of an anterior surgical approach. The patient was informed that data concerning the case would be submitted for publication, and he provided consent.
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