Langerhans cell histiocytosis (LCH) is a rare neoplastic proliferation of dysfunctional antigen presenting cells. Granulomatous in character, LCH may affect any organ system and any age group. Several cases worldwide are mostly studied among the pediatric population with only finite cases among adults.

This is a case of a 25-year old Filipino female who presented with granulomatous anterior chest lesions. Skin biopsy showed histiocytic predominance positive for CD1A. PET-CT showed involvement of the anterior ribs, and lymphadenopathies. A course of steroids and methotrexate was given prior to PET scan with noted improvement of lesions. Post imaging, targeted therapy was done with revised treatment management.

LCH is a rare histiocytic disease which behaves malignantly. Involvement may be unifocal or multifocal and its approach lies on the severity and extent of the disease. Despite limited resources and lack of available diagnostics at our locality, targeted treatment was conducted. As the first and only documented LCH case at our institution, challenges on the diagnostic and management required interdisciplinary approach and collaboration.

Keywords: Langerhans cell histiocytosis, Case report, CD1A

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