Haustein M, Terai N, Pablik J, Pillunat L E, Sommer F
Klinik und Poliklinik für Augenheilkunde, Universitätsaugenklinik der medizinischen Fakultät Carl Gustav Carus, TU Dresden, Fetscher Str. 74, 01307, Dresden, Deutschland,
Ophthalmologe. 2014 Jan;111(1):53-7. doi: 10.1007/s00347-013-2844-8.
Swelling of the upper eyelid in childhood is caused by a variety of diseases and is very often generated by inflammation but orbital tumors should always be considered in the differential diagnostics.
We report about a 4-year-old girl with a drug-resistant swelling of the upper eyelid and ptosis of the right eye. This case report demonstrates the route from initial clinical examination to diagnosis and additionally reviews the current status of therapeutic options.
After magnetic resonance imaging (MRI) and diagnostic excision, Langerhans cell histiocytosis (LCH) could be histologically proven. Visual acuity and levator muscle function improved from 0.5 to 1.25 and from 2 mm to 12 mm, respectively, by amblyopic prophylaxis and immunosuppressive therapy.
Persistent and drug-resistant swelling of the upper eyelid in childhood is also strongly suspicious for tumors. The suspicion of rare orbital tumors in children can be frequently substantiated by MRI. Biopsy and histological diagnosis are essential to plan adequate treatment and to estimate the prognosis. Particularly in Langerhans cell histiocytosis the methods of choice for over 10 years are specific immunochemical procedures (detection of protein s100 and CD1a).
儿童上睑肿胀由多种疾病引起，通常由炎症导致，但在鉴别诊断时应始终考虑眼眶肿瘤。
我们报告了一名4岁女童，其右眼上睑肿胀且耐药，伴有上睑下垂。本病例报告展示了从初始临床检查到诊断的过程，并另外回顾了治疗选择的现状。
经磁共振成像（MRI）和诊断性切除后，组织学证实为朗格汉斯细胞组织细胞增多症（LCH）。通过弱视预防和免疫抑制治疗，视力从0.5提高到1.25，提上睑肌功能从2毫米提高到12毫米。
儿童持续性和耐药性上睑肿胀也高度怀疑为肿瘤。儿童罕见眼眶肿瘤的怀疑通常可通过MRI得到证实。活检和组织学诊断对于规划适当的治疗和评估预后至关重要。特别是在朗格汉斯细胞组织细胞增多症中，十多年来的首选方法是特定的免疫化学程序（检测蛋白质s100和CD1a）。
