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CC BY-NC-ND 4.0 · J Neurol Surg Rep 2022; 83(03): e90-e94
DOI: 10.1055/a-1847-8245
Original Article

Resolution and Re-ossification of Orbital-Wall Langerhans Cell Histiocytosis Following Stereotactic Needle Biopsy

William C. Broaddus
1   Department of Neurosurgery, Virginia Commonwealth University, Richmond, Virginia, United States
,
Aravind Somasundaram
1   Department of Neurosurgery, Virginia Commonwealth University, Richmond, Virginia, United States
,
Matthew T. Carr 
1   Department of Neurosurgery, Virginia Commonwealth University, Richmond, Virginia, United States
,
Charles F. Opalak
1   Department of Neurosurgery, Virginia Commonwealth University, Richmond, Virginia, United States
,
Hope T. Richard
2   Department of Pathology, Virginia Commonwealth University, Richmond, Virginia, United States
,
Sharon B. Wolber
1   Department of Neurosurgery, Virginia Commonwealth University, Richmond, Virginia, United States
,
Hayri E. Sangiray
1   Department of Neurosurgery, Virginia Commonwealth University, Richmond, Virginia, United States
› Author Affiliations Funding None.
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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 magnetic resonance imaging 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.

Keywords

Langerhans cell histiocytosis - biopsy - stereotactic - resolution - re-ossification


Publication History

Received: 09 June 2021

Accepted: 29 March 2022

Accepted Manuscript online:
10 May 2022

Article published online:
19 July 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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