BACKGROUND: Despite the recent advent of various radiographic imaging techniques, it is still very difficult to correctly distinguish a pediatric @entity690 in the occipital condyle, which makes it further complicated to decide on the necessity of and the adequate timing for radical resection and craniocervical fusions. To establish a legitimate therapeutic strategy for this deep-seated lesion, surgical biopsy is a reasonable choice for first-line intervention. The choice of surgical approach becomes very important because a sufficient amount of histological specimen must be obtained to confirm the diagnosis but, ideally, the residual bony structures and the muscular structures should be preserved so as not to increase craniocervical instability. In this report, we present our experience with a case of solitary @entity1222 ( @entity1222 ) involving the occipital condyle that was successfully treated with minimally invasive surgical biopsy with a far lateral condylar approach supported by preoperative 3D computer graphic simulation. CASE REPORT: An 8-year-old @entity1 presented with @entity4048 . Magnetic resonance imaging and computed tomography (CT) revealed an @entity690 of the left occipital condyle. At surgery, the @entity1 was placed in the prone position. A 3-cm skin incision was made in the posterior auricular region, and the sternocleidomastoid and splenius capitis muscles were dissected in the middle of the muscle bundle along the direction of the muscle fiber. Under a navigation system, we approached the occipital condyle through the space between the longissimus capitis muscle and the posterior belly of the digastric muscle and lateral to the superior oblique muscle, verifying each muscle at each depth of the surgical field and, finally, obtained sufficient surgical specimen. After the biopsy, her craniocervical instability had not worsened, and chemotherapy was performed. Twelve weeks after chemotherapy, her @entity4048 had gradually disappeared along with her torticollis, and CT showed remission of the lesion and marked regeneration of the left occipital condyle. Within our knowledge, this is the first reported case of @entity1222 involving the occipital condyle. Although very rare, our case indicated that @entity1222 can be an alternative in the differential diagnosis of @entity690 in the craniocervical junction, in which early bone regeneration with sufficient cervical stability is expected after chemotherapy. CONCLUSIONS: In cases of pediatric @entity690 , when they initially presented with apparent cervical instability, craniocervical fusion may possibly become unnecessary after a series of treatments. Thus, the effort to maximally preserve the musculoskeletal structure should be made until its histological diagnosis is finally confirmed.

Solitary XXXX of the occipital condyle: a case report and review of the literature.

@entity1 :: ('9606', 'Species') :: ['girl', 'patient'] @entity1222 :: ('MESH:D006646', 'Disease') :: ['Langerhans cell histiocytosis', 'LCH'] @entity4048 :: ('MESH:D019547', 'Disease') :: ['neck pain'] @entity690 :: ('MESH:D030981', 'Disease') :: ['osteolytic lesion', 'osteolytic lesions']
@entity1222 :: (MESH:D006646,Disease) :: ['Langerhans cell histiocytosis']
