Demographics:
16 years old, Male
Indication:
Left eye ptosis and pain
Findings
- Ill-defined enhancing osseous lesion in the left orbital roof lateral to the left frontal sinus with intraorbital extension along the superior and lateral margins of the superior muscular complex and slight intracranial extension along the floor of the left anterior cranial fossa with surrounding thin dural thickening and enhancement
- Anterior extension in the lateral extraconal left orbit to the posterior margin of the lacrimal gland
- Moderate mucosal thickening of left anterior ethmoid air cells and the left frontal sinus
- No evidence of acute infarct, hemorrhage, intracranial mass effect, or hydrocephalus
Diagnosis
Langerhans cell histiocytosis (LCH)
Sample Report
Enhancing osseous lesion centered in the left orbital roof lateral to the left frontal sinus with intraorbital extension along the superior and lateral margins of the superior muscular complex and slight intracranial extension along the floor of the left anterior cranial fossa. Differential considerations include inflammatory lesions such as IgG4-related disease and Langerhans cell histiocytosis, infection, and neoplasm. Left frontoethmoid sinus disease, which may be reactive and is considered less likely to be the source for the left orbital roof lesion. Consider tissue sampling for further evaluation.
No evidence of acute intracranial abnormality.
Discussion