Paediatric Supraorbital Mass: A Case of Langerhans Cell Histiocytosis

Abstract

This is a case of 2-year-old boy who presented with painless right supraorbital swelling for 2 weeks. He had history of left humerus fracture and multiple scalp swelling. Examination revealed a hard, non-tender mass over right upper eye lid with downward placement of eye globe and limitation of extraocular muscle movement upon upward gaze. Systemic examination was unremarkable. MRI brain and orbit showed avid enhancing mass arising from right orbital roof. Histopathological examination of left humerus trucut biopsy revealed focal aggregation of histiocytes with scattered eosinophils. The diagnosis of LCH was further confirmed by positive CD1a and S100 protein staining on immunohistochemical studies. He was referred to oncology department for initiation of chemotherapy. Significant improvement was seen after the first cycle of chemotherapy. Keywords: Langerhans cell histiocytosis, supraorbital swelling