Langerhans cell histiocytosis (LCH) is a monoclonal proliferation of Langerhans cells forming granulomas in the bone, skin, and lungs. Bone lesions are characterized by a punched-out image. We report a case of LCH involving the left mandible.
The patient was a 41-year-old man. He visited a previous dental clinic due to pain of the left mandibular molars, and was diagnosed with acute apical periodontitis of the second molar. Panoramic radiographs showed a clear border of bone resorption at a distance from the root of the left lower second molar. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a clear borderline monocystic permeation image. Biopsy was performed, and a diagnosis of LCH was made. A systematic search revealed no lesions in other organs, and the final diagnosis was LCH (single system, single site). Steroids were administered comprising local injection weekly, for four weeks. Six months after treatment, CT showed bone formation.
Now, 5 years have passed since treatment, and the patient has followed a favorable course with no recurrence or disease affecting other organs.
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