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Yahiaoui S, Ghorbel A, Ben Zid K, Zarraa S, Kchaou L, FidaNoubigh, Kaabia W, Bouguerra F, Mousli A, Abidi R, Yousfi A, Nadia B, Nasr C. Spontaneous regression of an orbital Langerhans cell histiocytosis after biopsy: A case report. Spontaneous regression of an orbital Langerhans cell histiocytosis. Rare Tumors 2022; 14:20363613221135987. [PMID: 36277239 PMCID: PMC9583201 DOI: 10.1177/20363613221135987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/06/2022] [Accepted: 10/11/2022] [Indexed: 11/16/2022] Open
Abstract
Langerhans histiocytosis or Langerhans cell histiocytosis (LCH) is a rare benign pathology representing less than 1% of orbital tumors. It can cause either localized or generalized lesions, leading to the destruction of hard and soft tissues. Eosinophilic granuloma is the most benign form and the predominant clinical presentation of LCH. We report a case of eosinophilic granuloma with orbital involvement in an 18-year-old male patient. Orbital radiotherapy was initially planned, but finally it was not performed due to a spontaneous regression of the lesion after the incisional biopsy. The presented case supports an expectant attitude given the possibility of a spontaneous regression after the biopsy, especially in small lesions. However, long-term follow-up is essential given the risk of recurrence.
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Affiliation(s)
- Safia Yahiaoui
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
| | - Asma Ghorbel
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia,Asma Gorbel, Radiotherapy department,
Salah-Azaiz Institute, Bab Saadoun, Tunis 1006, Tunisia.
| | - Khadija Ben Zid
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
| | - Semia Zarraa
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
| | - Lina Kchaou
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
| | - FidaNoubigh
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
| | - Wael Kaabia
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
| | - Fadoua Bouguerra
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
| | - Alia Mousli
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
| | - Rim Abidi
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
| | - Amani Yousfi
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
| | - Boujelbene Nadia
- Pathology Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
| | - Chiraz Nasr
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
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Miller MJ, Hicks MJ, Foroozan R, Brodsky MC. A high-pressure situation. Surv Ophthalmol 2022:S0039-6257(22)00112-6. [PMID: 35970231 DOI: 10.1016/j.survophthal.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 08/03/2022] [Accepted: 08/08/2022] [Indexed: 10/15/2022]
Abstract
An 8-year-old boy presented with acute visual loss in the right eye and nausea, vomiting, and diplopia. Imaging revealed a right orbital apex mass. Biopsy showed Langerhans cell histiocytosis (LCH), and the patient was diagnosed with isolated orbital LCH causing an orbital apex syndrome. A 12-month cytarabine chemotherapy course was begun, during which the patient developed bilateral optic disc edema. He was diagnosed with cytarabine-induced intracranial hypertension, which was successfully treated with acetazolamide. The cytarabine course was completed with complete resolution of the LCH lesion. The ophthalmologic relevance of this rare disorder is discussed.
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Affiliation(s)
| | - M John Hicks
- Baylor College of Medicine, Houston, Texas, USA; Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas, USA; Department of Pathology, Texas Children's Hospital, Houston, Texas, USA
| | - Rod Foroozan
- Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA.
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Broaddus WC, Somasundaram A, Carr MT, Opalak CF, Richard HT, Wolber SB, Sangiray HE. Resolution and Re-ossification of Orbital Wall Langerhans Cell Histiocytosis Following Stereotactic Needle Biopsy. J Neurol Surg Rep 2022; 83:e90-e94. [PMID: 35864894 PMCID: PMC9296262 DOI: 10.1055/a-1847-8245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 03/29/2022] [Indexed: 10/29/2022] Open
Abstract
Introduction
Langerhans cell histiocytosis (LCH) is a rare disease that encompasses a spectrum of clinical syndromes. It is characterized by the proliferation and infiltration of white blood cells into organs or organ systems. Reports of management of these lesions have included biopsy, resection, curettage, radiation and/or chemotherapy.
Case Presentation
A 40-year-old man presented with a history of right proptosis and retro-orbital pain and was found to have a lytic mass involving the greater wing of the sphenoid extending into the right orbit. A stereotactic needle biopsy using neuronavigation demonstrated this to be LCH. After no further treatment, the mass spontaneously resolved, with virtual normalization of the orbital MRI at 10 months following the needle biopsy. The bony defect of the temporal bone caused by the mass also re-ossified following the needle biopsy.
Discussion
This report highlights the potential for an isolated LCH lesion to regress after simple needle biopsy, an outcome only rarely reported previously. Thus, expectant management of such lesions following biopsy or initial debridement should be considered prior to proceeding with additional treatment.
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Affiliation(s)
| | | | | | - Charles F Opalak
- Neurosurgery, Virginia Commonwealth University, Richmond, United States
| | - Hope T. Richard
- Pathology, Virginia Commonwealth University, Richmond, United States
| | - Sharon B. Wolber
- Neurosurgery, Virginia Commonwealth University, Richmond, United States
| | - Hayri E. Sangiray
- Neurosurgery, Virginia Commonwealth University, Richmond, United States
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Yoneoka Y, Hatase T, Watanabe N, Jinguji S, Okada M, Takagi M, Fujii Y. Early morphological recovery of the optic chiasm is associated with excellent visual outcome in patients with compressive chiasmal syndrome caused by pituitary tumors. Neurol Res 2014; 37:1-8. [DOI: 10.1179/1743132814y.0000000407] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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