Pathological fracture of axis odontoid caused by Rosai-Dorfman disease: A case report and literature review

Background Rosai-Dorfman disease, also known as sinus hisliocytosis with massive lymphadenopathy (SHML), is a benign lymphoproliferative disease that can affect all organs of the human body simultaneously. Such as nervous system, skeletal muscle system, digestive system, cardiovascular system and so on. It is a rare benign disease of unknown etiology. Some people believe that Rosai-Dorfman disease is a self-limiting disease that can resolve itself within a few months or some years, but there are also some cases with a long course of disease, or death due to multi-system and multi-organ invasion and destruction. Few cases of the skeletal system have been reported at home and abroad, and pathological fracture of the axis odontoid caused by the disease is more rare. Case description We report a 22-year-old woman with pathological fracture of the axis odontoid by Rosai-Dorfman disease。Pathological fracture of the axis odontoid (Rosai-Dorfman disease) was confirmed by transoropharyngeal pathological biopsy of the odontoid in our hospital. Then posterior cervical C1C2C3 vertebral reduction and internal fixation plus iliac bone grafting were performed, No other treatment such as radiotherapy or chemotherapy was performed after surgery. After 3 years of regular follow-up, the results showed that the bone defect area of the axis odontoid fracture was gradually reduced until it was completely healed, and the treatment effect was satisfactory. Conclusions For patients with pathological fracture of the axis odontoid caused by Rosai-Dorfman disease, through posterior cervical reduction, internal fixation, bone grafting and fusion, and sticking to wearing neck circumference after surgery, the odontoid fracture end can be completely healed, the bone defect area of the axis odontoid can be reduced, and the treatment plan is feasible.