A Case of Langerhans' Cell Histiocytosis of the Temporal Bone

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A case of Langerhans' cell histiocytosis of the temporal bone is reported. A 9-year-old boy presented with a 17-month history of right otorrhea. His condition had been previously treated as a case of chronic otitis media. His right external ear canal was found to be obstructed by an aural polyp. A biopsy was performed and pathological findings suggested Langerhans' cell histiocytosis. A CT scan revealed an osteolytic lesion of the superior wall of the external ear canal. Other osteolytic lesions were not found. The polyp mass was surgically removed. The three types of Langerhans' cell histiocytosis cannot be differentiated pathologically. This case however, was diagnosed as an eosinophilic granuloma, one of the three types of Langerhans' cell histiocytosis, because it was a slow-growing solitary lesion. As the presence of an aural polyp is a common symptom in cholesteatoma, especially in children, biopsies and CT scanning should be performed in order to differentiate from cholesteatoma when aural polyps are found.The prognosis of eosinophilic granuloma is generally favorable, but some cases have been reported to progress to the disseminated type in several years. Careful and long-term follow-up is necessary.
耳鼻咽喉科臨床学会の論文