Bilateral Temporal Bone Langerhans Cell Histiocytosis: Radiologic Pearls

Mira A. Coleman1, Jane Matsumoto2, Carrie M. Carr2, Laurence J. Eckel2, Amulya A. Nageswara Rao3, *
1 Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, Mayo Clinic, Rochester, Minnesota, USA
2 Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
3 Department of Pediatric and Adolescent Medicine/Division of Pediatric Hematology-Oncology, Mayo Clinic, Rochester, Minnesota, USA

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© Coleman et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Mayo Clinic, 200 First Street S.W., Rochester, MN 55905, USA; Tel: 507-284-2695; Fax: 507-284-0727; E-mail:


Langerhans cell histiocytosis (LCH) is a rare histiocytic disorder with an unpredictable clinical course and highly varied clinical presentation ranging from single system to multisystem involvement. Although head and neck involvement is common in LCH, isolated bilateral temporal bone involvement is exceedingly rare. Furthermore, LCH is commonly misinterpreted as mastoiditis, otitis media and otitis externa, delaying diagnosis and appropriate therapeutic management. To improve detection and time to treatment, it is imperative to have LCH in the differential diagnosis for unusual presentations of the aforementioned infectious head and neck etiologies. Any lytic lesion of the temporal bone identified by radiology should raise suspicion for LCH. We hereby describe the radiologic findings of a case of bilateral temporal bone LCH, originally misdiagnosed as mastoiditis.

Keywords: Langerhans cell histiocytosis, Bilateral temporal bone, Mastoiditis, CT, MRI.