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Yahiaoui S, Ghorbel A, Ben Zid K, Zarraa S, Kchaou L, FidaNoubigh, Kaabia W, Bouguerra F, Mousli A, Abidi R, Yousfi A, Nadia B, Nasr C. Spontaneous regression of an orbital Langerhans cell histiocytosis after biopsy: A case report. Spontaneous regression of an orbital Langerhans cell histiocytosis. Rare Tumors 2022; 14:20363613221135987. [PMID: 36277239 PMCID: PMC9583201 DOI: 10.1177/20363613221135987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/06/2022] [Accepted: 10/11/2022] [Indexed: 11/16/2022] Open
Abstract
Langerhans histiocytosis or Langerhans cell histiocytosis (LCH) is a rare benign pathology representing less than 1% of orbital tumors. It can cause either localized or generalized lesions, leading to the destruction of hard and soft tissues. Eosinophilic granuloma is the most benign form and the predominant clinical presentation of LCH. We report a case of eosinophilic granuloma with orbital involvement in an 18-year-old male patient. Orbital radiotherapy was initially planned, but finally it was not performed due to a spontaneous regression of the lesion after the incisional biopsy. The presented case supports an expectant attitude given the possibility of a spontaneous regression after the biopsy, especially in small lesions. However, long-term follow-up is essential given the risk of recurrence.
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Affiliation(s)
- Safia Yahiaoui
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
| | - Asma Ghorbel
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia,Asma Gorbel, Radiotherapy department,
Salah-Azaiz Institute, Bab Saadoun, Tunis 1006, Tunisia.
| | - Khadija Ben Zid
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
| | - Semia Zarraa
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
| | - Lina Kchaou
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
| | - FidaNoubigh
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
| | - Wael Kaabia
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
| | - Fadoua Bouguerra
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
| | - Alia Mousli
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
| | - Rim Abidi
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
| | - Amani Yousfi
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
| | - Boujelbene Nadia
- Pathology Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
| | - Chiraz Nasr
- Radiotherapy Department, Salah-Azaiz Institute, Bab Saadoun, Tunis, Tunisia
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Cunha JLS, de Carvalho RA, de Almeida OP, de Carvalho MGF, Soares CD. Langerhans cell histiocytosis mimicking a residual cyst. Oral Oncol 2022; 128:105831. [PMID: 35395554 DOI: 10.1016/j.oraloncology.2022.105831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 03/19/2022] [Indexed: 11/30/2022]
Abstract
Langerhans cell histiocytosis (LCH) is an uncommon myeloid neoplasm characterized by clonal neoplastic proliferation of Langerhans-type dendritic cells associated with a reactive inflammatory infiltrate composed predominantly of lymphocytes and eosinophils. Only three cases of LCH mimicking periapical lesions have been reported in the English-language literature to date. Herein, we report a rare case of LCH involving the mandible of a 45-years-old woman mimicking microscopically and radiographically a residual cyst. The patient underwent enucleation and curettage of the lesion. Microscopically, the lesion showed fibrous tissue with an intense inflammatory infiltrate and histiocytes with irregular to elongated nuclei with prominent nuclear grooves. The tumor cells were positive for S-100 protein, CD1a, and CD207. After careful evaluation through imaging tests to rule out lesions in other anatomical locations, the diagnosis was solitary LCH of the mandible. After four years of follow-up, the patient remained with no evidence of recurrence. This case emphasizes the importance of a carefully clinical, radiographic, and microscopical evaluation of bone lesions, including periapical or residual cysts, since some neoplasms can mimic common benign lesions of the jaws. Although conservative approaches to treating solitary mandibular bone lesions of LCH can be employed, long-term follow-up is strongly recommended.
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Affiliation(s)
- John Lennon Silva Cunha
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil.
| | | | - Oslei Paes de Almeida
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | | | - Ciro Dantas Soares
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil; Private Pathology Service, Natal, Brazil.
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3
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Al Abdulsalam A, Kapila K, Alherz M, Alsayegh M. Recurrence of a Langerhans Cell Histiocytosis bone lesion in a different site: A case report. Ann Med Surg (Lond) 2022; 75:103401. [PMID: 35242335 PMCID: PMC8885459 DOI: 10.1016/j.amsu.2022.103401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/09/2022] [Accepted: 02/21/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction Langerhans’ Cell Histiocytosis is a rare disease of unknown etiology, the pathogenesis of which involves both reactive and neoplastic processes. Despite potential resolution with conservative management, a rare recurrence in a distant site after 3 years from presentation in this case highlights the variability in the course of the disease and the need for larger studies to enable recognition and evidence-based management. Case presentation We present an unusual case below of a 25-year-old gentleman who presented with sternal pain and tenderness. Imaging showed a lytic lesion in the sternum which resolved spontaneously with oral analgesia. He presented 3 years later with back pain and a similar lytic lesion in the iliac bone was found and diagnosed as recurrent Langerhans Cell Histiocytosis with a biopsy. Clinical discussion There is a diverse array of documented presentations of Langerhans Cell Histiocytosis involving single or multiple systems, while its progression and outcomes are equally unpredictable from the current literature. In order to facilitate wider recognition, Langerhans Cell Histiocytosis should be considered in the differential diagnosis of recurrent lytic bone lesions. Conclusion Although this is a rare disease, there is currently an unmet need for understanding the determinants of recurrence and response to treatment. Langerhans Cell Histiocytosis is a rare disease of reactive and neoplastic pathologies. Spontaneous remissions can be followed by recurrences in distant sites. It should be considered in the differential diagnosis of recurring lytic bone lesions.
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Ono K, Okui T, Kunisada Y, Obata K, Masui M, Ryumon S, Ibaragi S, Nakamura T, Sasaki A. A case of langerhans cell histiocytosis of the mandible that spontaneously regressed after biopsy in a child. Clin Case Rep 2021; 9:e04321. [PMID: 34194804 PMCID: PMC8223692 DOI: 10.1002/ccr3.4321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/20/2021] [Accepted: 04/26/2021] [Indexed: 12/24/2022] Open
Abstract
In younger patients of LCH, we should consider that the effectiveness of follow-up without aggressive treatment for SS-type LCH in the oral and maxillofacial bone. However, there are very rare case in which an SS-type LCH recurred after showing a healing tendency. Regular follow-up must be performed even after healing.
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Affiliation(s)
- Kisho Ono
- Department of Oral and Maxillofacial SurgeryDentistry and Pharmaceutical SciencesOkayama University Graduate School of MedicineOkayamaJapan
| | - Tatsuo Okui
- Department of Oral and Maxillofacial SurgeryDentistry and Pharmaceutical SciencesOkayama University Graduate School of MedicineOkayamaJapan
- Department of Oral and Maxillofacial SurgeryFaculty of MedicineShimane UniversityShimaneJapan
| | - Yuki Kunisada
- Department of Oral and Maxillofacial SurgeryDentistry and Pharmaceutical SciencesOkayama University Graduate School of MedicineOkayamaJapan
| | - Kyoichi Obata
- Department of Oral and Maxillofacial SurgeryDentistry and Pharmaceutical SciencesOkayama University Graduate School of MedicineOkayamaJapan
| | - Masanori Masui
- Department of Oral and Maxillofacial SurgeryDentistry and Pharmaceutical SciencesOkayama University Graduate School of MedicineOkayamaJapan
| | - Shoji Ryumon
- Department of Oral and Maxillofacial SurgeryDentistry and Pharmaceutical SciencesOkayama University Graduate School of MedicineOkayamaJapan
| | - Soichiro Ibaragi
- Department of Oral and Maxillofacial SurgeryDentistry and Pharmaceutical SciencesOkayama University Graduate School of MedicineOkayamaJapan
| | - Tomoya Nakamura
- Department of Oral and Maxillofacial SurgeryDentistry and Pharmaceutical SciencesOkayama University Graduate School of MedicineOkayamaJapan
| | - Akira Sasaki
- Department of Oral and Maxillofacial SurgeryDentistry and Pharmaceutical SciencesOkayama University Graduate School of MedicineOkayamaJapan
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5
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Chugh A, Kaur A, Kumar Patnana A, Kumar P, Chugh VK. Unisystem Langerhans cell histiocytosis in maxillofacial region in pediatrics: comprehensive and systematic review. Oral Maxillofac Surg 2021; 25:429-444. [PMID: 33591444 DOI: 10.1007/s10006-021-00949-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 02/01/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND The study aimed to identify, enlist, and analyze cases of unisystem LCH in the maxillofacial pediatric population to understand the clinical presentation and encourage the consideration of this rare disease in the differential diagnosis. Langerhans cell histiocytosis (LCH) is an aggressive benign condition affecting mainly the pediatric population. It can be easily masked as periodontal disease in the maxillofacial region. Early diagnosis and a systemic evaluation are of utmost importance. METHODOLOGY We are presenting a complete review of literature in the pediatric population according to PRISMA guidelines for clinicopathologic, histopathological, immunohistochemistry, and treatment for unisystem LCH. The risk of bias assessment across studies was done using a Case series appraisal checklist by Guo et al. 53 RESULTS: Forty-nine articles (152 cases) were selected which met our inclusion and exclusion criteria to be included in our review. Most of the patients fall in 6-12 years of age with the involvement of the mandibular body region in 40.79% cases. This disease mainly presents as erythematous gingiva, pain, swelling, and mobile teeth. Management can range from minimal intervention to chemotherapy and surgery. CONCLUSION AND PRACTICAL IMPLICATIONS Although this is a rare condition, it should be considered especially in the pediatric population with periodontitis type lesions and floating teeth and comprehensive management should be followed. Early diagnosis of the disease is very important.
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Affiliation(s)
- Ankita Chugh
- Oral and maxillofacial surgery, Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Amanjot Kaur
- Oral and maxillofacial surgery, Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
| | - Arun Kumar Patnana
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Pravin Kumar
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vinay Kumar Chugh
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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6
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Almuzayyen A, Elhassan W, Alabbadi M. Intralesional Triamcinolone for Treating Mandibular Langerhans Cell Histiocytosis: A Case Report and Literature Review. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2019; 7:47-50. [PMID: 30787858 PMCID: PMC6381848 DOI: 10.4103/sjmms.sjmms_84_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Langerhans cell histiocytosis is a rare condition ranging in manifestation from a focal boney lesion to multisystem involvement. Several treatment modalities have been proposed including curettage, low-dose radiotherapy, chemotherapy and intralesional injection of corticosteroids. These treatment options can be used as a single or combined approach. Prognosis depends on the extent of systemic involvement, and solitary lesions respond favorable to treatment. Here, the authors report a case of a 10-year-old male patient with Langerhans cell histiocytosis affecting his right posterior mandible that was successfully treated with intralesional injection of triamcinolone in multiple sessions. Complete recovery was confirmed clinically and radiographically in 18 months from the time of diagnosis.
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Affiliation(s)
- Ahmed Almuzayyen
- Department of Surgery, Dental and Maxillofacial Surgery Unit, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Wahbi Elhassan
- Department of Surgery, Dental and Maxillofacial Surgery Unit, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Mousa Alabbadi
- Department of Surgery, Dental and Maxillofacial Surgery Unit, King Fahad Specialist Hospital, Dammam, Saudi Arabia
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7
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Tamura R, Maeda S, Terashi H. Reconstruction of a severe mandibular pathological fracture caused by Langerhans cell histiocytosis using a free fibula osteocutaneous flap:a case report. CASE REPORTS IN PLASTIC SURGERY AND HAND SURGERY 2018; 5:9-13. [PMID: 29372175 PMCID: PMC5769776 DOI: 10.1080/23320885.2017.1421468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 12/20/2017] [Indexed: 12/27/2022]
Abstract
Langerhans cell histiocytosis (LCH) is a rare disease in which Langerhans cells, which are bone marrow-derived antigen-presenting cells, proliferate in single or multiple organs. We successfully treated a patient with unifocal LCH of the mandible with malocclusion due to a severe pathological fracture, using reconstruction with a vascularised free bone.
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Affiliation(s)
- Ryosuke Tamura
- Department of Plastic Surgery, Hyogo Prefectural Awaji Medical CenterSumotoHyogoJapan.,Department of Plastic Surgery, Kobe University Graduate School of MedicineKobeHyogoJapan
| | - Sho Maeda
- Department of Plastic Surgery, Hyogo Prefectural Awaji Medical CenterSumotoHyogoJapan
| | - Hiroto Terashi
- Department of Plastic Surgery, Kobe University Graduate School of MedicineKobeHyogoJapan
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8
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Vargas A, Ramírez H, Ramírez P, Foncea C, Venegas B, Astorga P. Spontaneous remission of eosinophilic granuloma of the maxilla after incisional biopsy: a case report. Head Face Med 2016; 12:21. [PMID: 27251410 PMCID: PMC4890254 DOI: 10.1186/s13005-016-0118-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Accepted: 05/24/2016] [Indexed: 12/11/2022] Open
Abstract
Background Langerhans cell histiocytosis (LCH), previously known as Histiocytosis X, is an infrequent disease that congregates a wide spectrum of clinical presentations with variable systemic involvement. Unification of these diseases under only one category is based on the almost identical histopathologic features of the lesions, but the etiology and proper approach for each presentation remains controversial. The localized alternative of Langerhans cell histiocytosis (LLCH), known as Eosinophilic Granuloma (EG) of bone, is the predominant clinical presentation of LCH. The maxilla is involved in 1 % of the head and neck region cases, representing an uncommon condition in this area. Case Presentation In this clinical case report, it is described a case of a 16-year-old male patient with an asymptomatic osteolytic lesion at first upper left molar apical level, a finding detected on control radiographic images was reported as “Monostotic Eosinophilic granuloma of the maxillary bone”, which was later confirmed through an incisional biopsy. A surgical excision was initially planned, but finally it was not performed due to a spontaneous healing of the lesion after the incisional biopsy. Conclusions The presented case supports a conservative approach in the management of solitary EG of maxillary and mandibular bone lesions and even supports an expectant attitude in the course of treatment given the possibility of a spontaneous regression after the biopsy, especially in small lesions.
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Affiliation(s)
- Alex Vargas
- DDS. Associated Professor of the Oncology and Maxillofacial Surgery Department, Medicine Faculty, Pontificia Universidad Católica de Chile, Santiago, Chile.
| | - Hernán Ramírez
- DDS. Associated Professor of the Oncology and Maxillofacial Surgery Department, Medicine Faculty, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pablo Ramírez
- Assistant Professor of Hematology Department, Medicine Faculty, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Camila Foncea
- Resident of Oral and Maxillofacial Surgery Program, Medicine Faculty, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Bernardo Venegas
- Oral Pathologist at the University of Talca and Carlos Van Buren Hospital of Valparaíso, Valparaíso, Chile
| | - Paula Astorga
- Observer of the Oncology and Maxillofacial Surgery Department, Medicine Faculty, Pontificia Universidad Católica de Chile, Santiago, Chile
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Plona GA, Wiltz M, Kelsch R. Spontaneous resolution of an eosinophilic granuloma of the mandible following open biopsy. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 122:e60-3. [PMID: 27033671 DOI: 10.1016/j.oooo.2015.11.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 11/10/2015] [Accepted: 11/15/2015] [Indexed: 12/15/2022]
Abstract
Langerhans cell histiocytosis X is a clonal proliferation of dendritic cells of the immune system, which can affect multiple organ systems and range in behavior from a benign inflammatory process to a much more aggressive process. Only few isolated cases have been reported in the jaws. This case represents an example of Langerhans cell histiocytosis X in the mandible, which resolved following incisional biopsy without any further surgical intervention.
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Affiliation(s)
- Gregory A Plona
- Chief Resident at Montefiore Medical Center, Bronx, NY, USA.
| | - Mauricio Wiltz
- Assistant Professor, Division of Oral and Maxillofacial Surgery, Department of Dentistry, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Robert Kelsch
- Assistant Professor, Departments of Dental Medicine and Pathology and Laboratory Medicine, NSLIJ Health System, New Hyde Park, NY; Attending, Departments of Dentistry and Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
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10
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Esen A, Işık K, Dolanmaz D. Treatment of mouth and jaw diseases with intralesional steroid injection. World J Stomatol 2015; 4:87-95. [DOI: 10.5321/wjs.v4.i2.87] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 12/11/2014] [Accepted: 01/19/2015] [Indexed: 02/06/2023] Open
Abstract
Many lesions of the oral region are treated with surgical methods such as curettage and resection. Chemotherapy and radiation therapy with or without surgical intervention can be used as an adjunct in some cases. Intralesional steroid injection is a conservative procedure which is already used in various regions of the body and joints. This technique is used also for a number of mouth and jaw lesions. Localized langerhans cell histiocytosis, central giant cell granuloma, oral submucous fibrosis, oral lichen planus, lichen sclerosus of the oral mucosa, lymphatic malformations and orofacial granulomatosis can be considered among these diseases. The purpose of this review is to investigate the effects of intralesional steroid injections in the treatment of oral diseases.
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11
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Shevale VV, Ekta K, Snehal T, Geetanjal M. A rare occurrence of Langerhans cell histiocytosis in an adult. J Oral Maxillofac Pathol 2015; 18:415-9. [PMID: 25948998 PMCID: PMC4409188 DOI: 10.4103/0973-029x.151335] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 01/16/2015] [Indexed: 12/16/2022] Open
Abstract
Langerhans Cell Histiocytosis (LCH) is a disease process characterized by accumulation and infiltration of cells, showing ultrastructural and immunohistochemical similarities to Langerhans’ cell, in the affected tissues. It exhibits extreme clinical heterogeneity. LCH was historically divided into 3 clinical entities based on extent of tissue involvement and severity of presentation. These 3 entities were eosinophilic granuloma, Hand-Schuler-Christian disease, Letterer-Siwe disease. Owing to similarities of their histologic appearance, they were grouped together under the term histiocytosis X. It was recently changed to LCH, emphasizing the primary cell involved in the disease process. LCH is a rare disease with an incidenceestimated to be 4.0 to 5.4 per million population. Males are affected twice as frequently as females. The disease may occur at any age with peak incidence in children aged 1 to 3 years. We describe an unusual case of a 65-year-old man who presented with painless swelling in anterior region of mandible.
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Affiliation(s)
- Vruturaj V Shevale
- Department of Oral Pathology, Dr. Dnyandeo Yashwantrao Patil Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - K Ekta
- Department of Oral Pathology, Dr. Dnyandeo Yashwantrao Patil Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - T Snehal
- Department of Oral Pathology, Dr. Dnyandeo Yashwantrao Patil Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - M Geetanjal
- Department of Oral Pathology, Dr. Dnyandeo Yashwantrao Patil Dental College and Hospital, Navi Mumbai, Maharashtra, India
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Heath JL, Burgett SE, Gaca AM, Jaffe R, Wechsler DS. Successful treatment of pediatric histiocytic sarcoma using abbreviated high-risk leukemia chemotherapy. Pediatr Blood Cancer 2014; 61:1874-6. [PMID: 24888336 DOI: 10.1002/pbc.25100] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 01/22/2014] [Indexed: 12/22/2022]
Abstract
Histiocytic sarcoma (HS) is a malignant tumor composed of proliferating cells of histiocytic origin. True HS is exceedingly rare, particularly in pediatric patients. These tumors are frequently aggressive, and outcome for patients with HS has traditionally been poor. There is currently no consensus on the optimal management of these tumors, with the literature consisting largely of case reports and small case series utilizing a wide variety of therapies. We describe a case of HS in an 8-year-old female who was successfully treated with an abbreviated leukemia chemotherapy regimen.
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Affiliation(s)
- Jessica L Heath
- Department of Pediatrics, Division of Pediatric Hematology-Oncology, Durham, North Carolina
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13
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[Osteolytic lesion of the ilium]. Radiologe 2013; 53:908-12. [PMID: 23831936 DOI: 10.1007/s00117-013-2527-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Yee KS, Combs PD, Kelley PK, George TM, Harshbarger RJ. Resorption of PDLLA plates as a nidus for recurrent langerhans cell histiocytosis. Pediatr Neurosurg 2013; 49:243-7. [PMID: 24902626 DOI: 10.1159/000362341] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 03/17/2014] [Indexed: 11/19/2022]
Abstract
Resorbable plating systems have been adapted into routine use for craniofacial reconstruction in children. After implantation in some patients, the area around the plates can develop palpable and visible fibrous capsules, with underlying bone resorption and a significant foreign-body giant cell reaction. The reaction is usually self-limited. We report a case in which Langerhans cell histiocytosis was resected, and then recurred at the sites of resorbing plate and screw placement in association with a foreign-body giant cell reaction.
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Affiliation(s)
- Kristen S Yee
- Division of Plastic Surgery, University of California, Los Angeles, Calif., USA
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15
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Slater LJ. Spontaneous regression of large mandibular lesions: consider Langerhans cell histiocytosis. Dentomaxillofac Radiol 2011; 40:534. [PMID: 22065805 DOI: 10.1259/dmfr/13193131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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16
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Murray M, Dean J, Slater L. Multifocal Oral Langerhans Cell Histiocytosis. J Oral Maxillofac Surg 2011; 69:2585-91. [DOI: 10.1016/j.joms.2011.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Accepted: 01/04/2011] [Indexed: 10/18/2022]
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Esen A, Dolanmaz D, Kalayci A, Günhan O, Avunduk MC. Treatment of localized Langerhans' cell histiocytosis of the mandible with intralesional steroid injection: report of a case. ACTA ACUST UNITED AC 2010; 109:e53-8. [PMID: 20123398 DOI: 10.1016/j.tripleo.2009.10.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2009] [Revised: 10/01/2009] [Accepted: 10/09/2009] [Indexed: 01/13/2023]
Abstract
Localized Langerhans cell histiocytosis (LLCH), formerly known as eosinophilic granuloma, mainly affects the skull, mandible, vertebrae, and ribs in children and the long bones of adults. Symptoms range from none to pain, swelling, and tenderness over the site of the lesion. General malaise and fever occasionally are present. Radiographically, lesions appear as radiolucent areas with well demarcated borders. LLCH may resolve spontaneously after biopsy in a period of months to years. However, if features include continuous pain, decrease of function, pathologic fractures, migration and resorption of teeth, or rapid progression, then active treatment needs to be considered. Treatment approaches include surgery, radiotherapy, chemotherapy, and intralesional injection of corticosteroids. In children with mandibular LLCH, 1 dose of methyprednisolone succinate injection has proven to be adequate. However, injections have not been performed in cases involving pathologic fracture. We report a new case of LLCH of the mandible that caused a pathologic fracture in an adult patient. Repeated intralesional corticosteroid injections resulted in fracture line disappearance within 14 months and lesion healing by the end of the 36-month follow-up.
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Affiliation(s)
- Alparslan Esen
- Department of Oral and Maxillofacial Surgery, Medical Park Hospital, Antalya, Turkey.
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Loeb I, Shahla M, Javadian R, Hermans P. [Pathological mandibular fracture]. REVUE DE STOMATOLOGIE ET DE CHIRURGIE MAXILLO-FACIALE 2007; 108:159-61. [PMID: 17383697 DOI: 10.1016/j.stomax.2006.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2006] [Accepted: 12/20/2006] [Indexed: 05/14/2023]
Affiliation(s)
- I Loeb
- Service de stomatologie et chirurgie maxillofaciale, CHU Saint-Pierre, 1000 Bruxelles, Belgique.
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Nakamura S, Bessho K, Nakao K, Iizuka T, Scott RF. Langerhans' cell histiocytosis confined to the jaw. J Oral Maxillofac Surg 2005; 63:989-95. [PMID: 16003628 DOI: 10.1016/j.joms.2004.07.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Putters TF, de Visscher JGAM, van Veen A, Spijkervet FKL. Intralesional infiltration of corticosteroids in the treatment of localised langerhans' cell histiocytosis of the mandible Report of known cases and three new cases. Int J Oral Maxillofac Surg 2005; 34:571-5. [PMID: 16053880 DOI: 10.1016/j.ijom.2004.10.020] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2003] [Revised: 06/30/2004] [Accepted: 10/26/2004] [Indexed: 12/13/2022]
Abstract
Langerhans' cell histiocytosis (LCH) can involve virtually any site and organ of the body, either as an isolated lesion or as a widespread systemic disease. Bone can be involved as a part of generalised disease or as a separate entity, formerly known as eosinophilic granuloma. The clinical cause of localised LCH (LLCH) to bone is generally benign. Solitary bone lesions may resolve spontaneously after diagnostic biopsy in a period of months to years. If treatment is indicated, as in larger lesions with pain, swelling and risk for spontaneous fracture, the disease can be controlled by chemotherapy or local measures such as surgical curettage, low-dose radiotherapy and intralesional injection of corticosteroids. There are no controlled studies in the literature comparing outcomes of these treatment modalities because of low incidence of the disease and general tendency to regress. Three patients (female, 28 months; male, 9 years; male, 15 years) with LLCH of the mandible were treated in an one stage procedure with intralesional injection of 80, 40 and 80 mg methylpredisolone succinate, respectively, as the primary form of treatment. Patients were seen for clinical and radiological evolution 1, 3, 6, 9 and 12 months after treatment, and yearly thereafter. The overall outcome was excellent. The lesions showed clinically and radiologically complete remission approximately 6 months after treatment. There were no complications nor morbidity of the treatment. After a follow-up period of 12 months, the patients are well with no evidence of residual disease on radiographs. Local injection of corticosteroids should be the initial choice of treatment of LLCH of the mandible, because of the favourable treatment outcome in this disease and possible complications and lasting effects of surgery, radiotherapy and chemotherapy.
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Affiliation(s)
- Th F Putters
- Department of Oral and Maxillofacial Surgery, University Hospital Groningen, 9700 RB Groningen, The Netherlands.
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