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Langerhans' Cell Histiocytosis of the Temporal Bone in Pediatric Patients

Imaging and Follow-Up

F. Fernández-Latorre1, F. Menor-Serrano2, S. Alonso-Charterina1 and J. Arenas-Jiménez1

1 Department of Radiology, Hospital General Universitario de Alicante, C. Pintor Baeza s.n., Alicante 03010, Spain.
2 Department of Pediatric Radiology, Hospital Universitario La Fe, Avda. Campanar, 21, Valencia 46009, Spain.



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  		Fig. 1 .—5-year-old boy who presented with bilateral postauricular masses and history of acute otitis media.

A, Axial CT scan obtained with bone window shows large bilateral temporomastoid bone destruction extending to left labyrinth (arrows) and right ossicular chain.

 


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  		Fig. 1 .—5-year-old boy who presented with bilateral postauricular masses and history of acute otitis media.

B, Two years after local administration of steroids, axial CT scan with bone window reveals nearly complete reossification and persistent opacification of left middle ear and mastoid.

 


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  		Fig. 2 .—11-month-old male infant who presented with bilateral otomastoiditis and right postauricular soft-tissue mass. Axial contrast-enhanced CT scan shows bilateral mastoid destruction extending to temporal squama on right. Note bilateral enhancing soft-tissue masses (arrows) with extradural extension in right temporal fossa.

 


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  		Fig. 3 .—10-month-old female infant who presented with left postauricular mass.

A, Axial contrast-enhanced CT scan shows destructive bone lesion in left mastoid with large, nonhomogeneous, enhancing mass. Note internal hyperattenuated areas representing remaining bone (arrows).

 


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  		Fig. 3 .—10-month-old female infant who presented with left postauricular mass.

B, One year after systemic administration of chemotherapy, axial contrast-enhanced CT scan reveals marked reduction of left mastoid mass and new destructive lesions (arrows) in right mastoid and sphenoid bones.

 


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  		Fig. 4 .—13-year-old girl with diplopia and ophthalmoplegia.

A, Axial contrast-enhanced CT scan reveals osseous destruction limited to right petrous apex (arrows).

 


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  		Fig. 4 .—13-year-old girl with diplopia and ophthalmoplegia.

B, Axial T2-weighted spin-echo MR image (TR/TE, 2200/80) shows hyperintense mass replacing normal signal void of petrous apex (arrow).

 


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  		Fig. 4 .—13-year-old girl with diplopia and ophthalmoplegia.

C, Coronal T1-weighted spin-echo MR image (600/15) better shows extension of accompanying isointense-to-hypointense mass (arrows) replacing fatty marrow of petrous apex and partially occupying cerebellopontine angle.

 


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  		Fig. 4 .—13-year-old girl with diplopia and ophthalmoplegia.

D, Coronal contrast-enhanced T1-weighted spin-echo MR image (600/15) shows strongly homogeneous enhancement of well-defined mass closely related to temporal lobe.

 


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  		Fig. 4 .—13-year-old girl with diplopia and ophthalmoplegia.

E, Two years after intralesional administration of steroids, coronal enhanced T1-weighted image shows no mass, and patient remains asymptomatic.

 

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