[Intraorbital extraocular Langerhans' cell granuloma: primary surgical approach. Why? - case report].
We present a case in which a patient with intraorbital Langerhans' cell granuloma, with anatomical and functional skills compromised by intraorbital hypertension, which was treated with urgency orbitotomy by cranial approach. Male, two years-old, presented conjuntival proptosis, red eye, complete ophthalmoplegy, exophthalmos, with non-fotoreactive mydriasis and blepharoptosis of the right eye. Fundoscopy presented venous enlargement with optic disc edema. A cranial approach with orbitotomy was carried out, removed the lesion with total remission of clinical presentation and anatomic appearance as well. The handling of Langerhans' cell granuloma can vary from primary surgical approach as corticotherapy to chemotherapy and radiotherapy. In this case, the surgery was the first option due to the imminent risk of loss of visual function.
Serviço de Neurocirurgia do Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul - Porto Alegre (RS) - Brasil. jgvalentim@uol.com.br
João Guilherme
JG
Valentim Neto
Cristina Góes
CG
Schaurich
D002675:Child, Preschool; D004803:Eosinophilic Granuloma / Q000473:pathology / Q000601:surgery*; D006646:Histiocytosis, Langerhans-Cell / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D013508:Ophthalmologic Surgical Procedures / Q000379:methods; D009916:Orbital Diseases / Q000473:pathology / Q000601:surgery*; D014792:Visual Acuity / Q000502:physiology