Thoracoscopic video-assisted partial resection of rib for pain control in patient with atypical pulmonary and bone Langerhans histiocytosis

Introduction : Langerhans histiocytosis (LH) is a rare disease that occurs in 1-2:2 millions of people, which affects mainly children and adults between twenty and forty years old. Bones affection is an rarely occurs. Clinical case : A 19 year old female with severe pain and discomfort of left subskapular area. After CT procedure, it was found that there are bilaterally a great number of small diffusely scattered nodular lesions in the lung parenchyma and formations, destructed cortex on the 5-th rib with the suspected for histiocytosis X. ![Figure][1] Treatment: A video-assisted thoracoscopic (VATS) partial resection of the fifth rib has been made, under three port. Lung biopsy has been made over several suspected lesions. The postoperative period has been uneventful. The pain and the discomfort were reduced. ![Figure][1] Conclusion : VATS resection of the rib could be a good modern approach to eradicate or interference of pain in the rib LH. VATS remains the ultimate cross-cutting unique therapeutic approach for the treatment of the bone Langerhans-cellular histiocytosis and change the quality of life in these patients. [1]: pending:yes