Grand Rounds
Section outline
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A previously healthy adolescent presented to an emergency department reporting several weeks of pain and swelling around the right eye. He was treated briefly with systemic antibiotics and steroids without sustained improvement. A CT scan revealed a lytic bone lesion within the right orbit, and a subsequent MRI revealed a heterogeneous mass. A tissue sample was obtained via orbitotomy and pathology of the specimen was found to be consistent with Langerhans cell histiocytosis (LCH). LCH is a neoplastic disorder characterized by the accumulation of pathologic histiocytes. LCH is rare but seen most commonly in children. Presentation is highly variable, with bone being the most common site of occurrence. The treatment and prognosis depend on the location of the initial lesion and the extent of the disease. This patient's disease was confined to the orbit, but given the high-risk location was started on systemic chemotherapy. He continues to be closely monitored.
Presentation Date: 05/28/2026
Issue Date: 05/29/2026
