Abstract / Summary
We present a rare case describing the clinical course of a seven-year-old girl presenting with left periorbital swelling, initially managed as preseptal cellulitis.The periorbital swelling was unresponsive to multiple courses of antibiotics.Magnetic resonance imaging (MRI) of the head and orbits revealed a 2.3 × 2.4 × 2.1 cm mass involving the superolateral aspect of the left orbit.The lesion was predominantly hypointense on T1weighted images and demonstrated mixed signal intensity on T2-weighted images.Post-contrast imaging demonstrated peripheral enhancement with internal septations.Concerns for mass effect due to the tumor size and location prompted surgical resection, with histopathologic examination confirming the diagnosis of Langerhans cell histiocytosis (LCH).Given the central nervous system (CNS)-risk orbital location, the patient completed a 52-week course of vinblastine and prednisone, consistent with a standard 12-month regimen.At the 12-month clinical follow-up after completion of chemotherapy, she remained clinically stable without evidence of recurrence.This case highlights the importance of considering rare diagnoses in pediatric patients with atypical or nonresponsive symptoms, particularly when clinical or laboratory findings do not support an infectious etiology.