Langerhans cell histiocytosis with periorbital cellulitis.

PURPOSE: To report a case of Langerhans cell histiocytosis presenting as periorbital cellulitis.

DESIGN

Interventional case report.

METHODS

A 3-year-old girl presented with periorbital swelling of the right upper lid laterally of two days' duration. A history of recent eye trauma was reported.

RESULTS

Computed tomography showed a soft tissue mass that eroded the frontozygomatic suture. The lesion was debulked through a lateral orbitotomy. Electron microscopy disclosed Birbeck granules. Immunohistochemistry stained positively for CD68 and CD1a antigenic determinants.

CONCLUSIONS

Although rare, Langerhans cell histiocytosis can cause acute periorbital cellulitis in children. Trauma can induce an inflammatory response, allowing for earlier diagnosis of the orbital lesion.