Langerhans cell histiocytosis occurring at critical sites can cause both diagnostic difficulty and risk for morbidity. We present a case report of a 17 year old male who presented with neck pain following a sports injury. He was initially treated with analgesia but due to persistent pain he presented to the emergency department. A plain radiograph revealed a pathological fracture with osteolytic destruction of C4. Further investigations and surgical spinal stabilisation under orthopaedic care revealed a biopsy proven diagnosis of solitary histiocytosis of C4. He recovered completely with normal function. This case report contributes to the clinical experience of this rare entity and gives a review of the literature on this rare but highly significant disease.
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