Orbital Manifestation of Langerhans Cell Histiocytosis in a Child - A Diagnostic Dilemma

Langerhans Cell Histiocytosis (LCH) is a rare and variable disease process that mimics inflammatory and sometimes malignant disease. Diagnosis is challenging as it may simulate abscess, hematoma, acute dacryocystitis and neuroblastoma in young children. We describe here a case of Langerhans cell histiocytosis in a young child, who presented with right superolateral orbital swelling and proptosis. He was initially treated as subcutaneous abscess with antibiotic and partially responded for a brief duration. Subsequently, he was confirmed LCH by radiological imaging and immunohistochemical marking. Thus, clinicians should consider Langerhans cell histiocytosis in their differential diagnosis, particularly in young children with similar presentation.