Langerhans cell histiocytosis can occur at any age with a peak incidence from age 1 to 4 years in an estimated 2 to 5 children per million per year. Boys are affected twice as often as girls. There is no race predilection, and LCH is a sporadic disease,1 reported in bone, skin, lymph nodes, thymus, ears, bone marrow, blood, liver, spleen, lungs, endocrine organs (except adrenals and gonads), gastrointestinal tract, and central nervous system.1- 4 Bone involvement is seen with pain and swelling, sometimes accompanied by pathologic fracture. The skull is most commonly affected followed by long bones, flat bones, and vertebrae. Vertebral involvement can lead to spinal cord compression or injury. Radiographic findings typically reveal well-defined osteolytic lesions with marked periosteal reaction. Bone scan and magnetic resonance imaging are less helpful diagnostic tools than plain films. Definitive diagnosis is made by bone biopsy.