Sarkar Subhra, Singh Maneesh, Nag Dipanwita, Dutta Himadri, Banerjee Anita, Bhaduri Gautam, Jha Arindam
Regional Institute of Ophthalmology, Calcutta Medical College, Kolkata 700073.
J Indian Med Assoc. 2007 Apr;105(4):218, 220.
A case of unifocal Langerhans' cell histiocytosis or eosinophilic granuloma in a child is reported where the frontal, zygomatic and maxillary bones of the left orbital wall are affected. As eosinophilic granuloma is a rare disease and the involvement of maxillary bone in orbital eosinophilic granuloma is not well documented in the literature, this case is reported for its unusual involvement of 3 bones at a single site. The diagnosis was established by clinical, radiological and histological findings. As no other system or site was involved and considering the osseous involvement of multiple bones at one site, local radiotherapy was preferred as the mode of treatment. The patient responded favourably to radiotherapy with reduction of proptosis and tumour mass but there was no visual recovery. In the absence of universal agreement over the mode of treatment, the result emphasises the probable benign nature of the tumour and the need to withhold more aggressive treatment modalities for extensive multisystem involvements.
报告了一例儿童单灶性朗格汉斯细胞组织细胞增多症或嗜酸性肉芽肿病例,该病例累及左侧眶壁的额骨、颧骨和上颌骨。由于嗜酸性肉芽肿是一种罕见疾病,且文献中关于眼眶嗜酸性肉芽肿累及上颌骨的记载并不充分,因此报告此病例是因其在单一部位不寻常地累及了三块骨头。通过临床、放射学和组织学检查结果确诊。由于未累及其他系统或部位,且考虑到单一部位多块骨头的骨质受累情况,首选局部放疗作为治疗方式。患者对放疗反应良好,眼球突出和肿瘤肿块减轻,但视力未恢复。鉴于在治疗方式上尚未达成普遍共识,该结果强调了肿瘤可能的良性性质以及对于广泛多系统受累情况需避免采用更激进治疗方式的必要性。