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Nazemisalman B, Zarabadi MS. Oral manifestation as the only sign of Langerhans cell histiocytosis: A case report. Clin Case Rep 2024; 12:e8410. [PMID: 38213932 PMCID: PMC10781892 DOI: 10.1002/ccr3.8410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 12/14/2023] [Accepted: 12/17/2023] [Indexed: 01/13/2024] Open
Abstract
Key Clinical Message The manifestations of Langerhans cell histiocytosis can be limited in the oral cavity, including gingival recession, tooth mobility, and bone destruction. Dentists play a crucial role in the early detection and management of these oral symptoms, which can significantly impact the overall prognosis and quality of life for patients with this serious disease. Abstract The hyperplastic activity of bone marrow can lead to excessive histocyte proliferation, called Langerhans cell histiocytosis (LCH). Based on the accumulation location, it has various organ involvement, including skin, bone, and so forth. Oral manifestations such as tooth involvement, bone lesions, mucosal ulcers, and periodontal problems can occur, and they might be the only manifestation of LCH. A subtle diagnosis is crucial and can be started with dental examinations. A 5-year-old girl was examined with the chief complaint of gingival recession with no pain, caries, or calculus. The clinical and radiographical assessment led to further immunohistochemical (IHC) evaluations. The diagnosis was LCH based on S-100 and cluster of differentiation 1a (CD1a) markers. LCH can involve different cells and tissues locally or generally. The early detection and treatment of LCH increase children's survival rate and quality of future life. Therefore, an accurate diagnosis is important among dentists. They must consider that abnormal mobility, gingival, or periodontal problems with no logical cause might warn about a latent problem. Sometimes extraction of loose teeth is not the end of treatment; it is the start of neglecting a serious disease.
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Affiliation(s)
- Bahareh Nazemisalman
- Department of Pediatric Dentistry, School of DentistryZanjan University of Medical SciencesZanjanIran
| | - Mobina Sadat Zarabadi
- Department of Pediatric Dentistry, School of DentistryZanjan University of Medical SciencesZanjanIran
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Burtsev EA, Bronin GO. Langerhans Cell Histiocytosis in Children: Literature Review. CURRENT PEDIATRICS 2023. [DOI: 10.15690/vsp.v22i1.2520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Relevant information on Langerhans cell histiocytosis development and course in children is presented. The current concepts of disease pathogenesis, principles of its severity evaluation, patients stratification into risk groups, as well as of clinical course features are described. Modern approaches to the disease treatment via targeted therapy are summarized and analyzed.
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Lavaee F, Nazhvani AD, Afshari A. A case report of adult Langerhans cell histiocytosis and review of the literature. Clin Case Rep 2023; 11:e6927. [PMID: 36789309 PMCID: PMC9913190 DOI: 10.1002/ccr3.6927] [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: 09/14/2022] [Revised: 12/25/2022] [Accepted: 01/22/2023] [Indexed: 02/12/2023] Open
Abstract
Langerhans cell histiocytosis (LCH) is an uncommon proliferative disease with an unknown cause. Its clinical manifestations vary and can involve a variety of organs. To diagnose LCH, radiographs, histopathological and immunohistochemical findings are essential. The gold standard for a definite diagnosis is positive CD1a/CD207 and S100 in the immunohistochemical results. Different treatment plans are available for patients struggling with LCH. To our knowledge, the LCH incidence rate is about 8.9 in one million children and 1-2 cases in one million adults. Our case shows the importance of early diagnosis of this rare condition for the prevention of any further spreading. This case report is about a 35-year-old male patient struggling with diabetes insipidus with a chief complaint of tooth mobility. Based on his X-ray radiographs, osteolytic lesions were found. A biopsy was performed, and due to histopathological and immunohistochemical findings, it was diagnosed as a case of LCH in adults. This paper shows that although the incidence rate of LCH is rare in adults, dealing with a patient struggling with diabetes insipidus and osteolytic bone lesions with an unknown cause, LCH must be taken into consideration. Due to the fact that LCH's first manifestations are mostly first oral, its good prognosis in the early stages, and if it progresses, it can turn fatal, it is important that dentists are aware of this disease, its clinical manifestations, and patient management. In case of suspicion, X-ray examination, biopsy, histopathological, and immunohistochemical exams must be performed.
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Affiliation(s)
- Fatemeh Lavaee
- Oral and Dental Disease Research Center, Oral and Maxillofacial Medicine Department, School of DentistryShiraz University of Medical SciencesShirazIran
| | - Ali Dehghani Nazhvani
- Oral and Maxillofacial Pathology Department, Biomaterials Research CenterSchool of dentistry, Shiraz University of Medical SciencesShirazIran
| | - Aylar Afshari
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
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Zhang Q, Wu X, Wang X, Pan E, Ying L. Molecular and oral manifestations of langerhans cell histiocytosis preceding acute myeloid leukemia. BMC Oral Health 2022; 22:386. [PMID: 36064398 PMCID: PMC9446764 DOI: 10.1186/s12903-022-02410-z] [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: 04/20/2022] [Accepted: 08/26/2022] [Indexed: 12/02/2022] Open
Abstract
Background Langerhans cell histiocytosis (LCH) is a heterogeneous neoplastic disorder that is rarely seen in patients aged 60 years and older. It is reported that elderly patients with LCH have a higher chance of having malignancies. In the oral cavity, patients with LCH can present with mucosal ulcers and extensive osteolysis, making it difficult for clinicians to make a proper diagnosis. Case presentation We reported an 82-year-old Chinese woman with oral symptoms as the first presentation of LCH, and eventually developed acute myeloid leukemia (AML). She suffered diffuse ulcers involving the entire gingival mucosa and the left half hard palate, and had lost several teeth. Genomic DNA sequencing of the cells from LCH revealed multiple mutations in TET2, BRAF, SRSF2, NRAS, MAP2K4 and so on. The patient declined the BRAFV600E inhibitor (Vemurafenib). Although a dramatic improvement of the oral ulcers was achieved after symptomatic treatment, the patient developed acute myeloid leukemia (AML) and died. Conclusions This report presented the diagnostic difficulties of LCH with oral manifestations and highlighted the importance of radiological assessments and laboratory tests. Moreover, many of the mutations detected in our LCH patient are frequently seen in AML, suggesting that AML and LCH cells in this patient share the same origin.
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Affiliation(s)
- Qi Zhang
- Department of Hematology, The Second Hospital of Dalian Medical University, Dalian, China
| | - Xiaoting Wu
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaobo Wang
- Department of Hematology, The Second Hospital of Dalian Medical University, Dalian, China
| | - Evenki Pan
- Nanjing Geneseeq Technology Inc., Nanjing, China
| | - Li Ying
- Department of Gastroenterology, The Second Hospital of Dalian Medical University, Dalian, China.
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Bhavsar YD, Dudhatra AV, Vyas HS, Pandya RB, Joshi AP. A Rare Case of Combined Langerhans Cell Histiocytosis and Adult-Onset Xanthogranuloma: A Case Report. Cureus 2022; 14:e28640. [PMID: 36196323 PMCID: PMC9525050 DOI: 10.7759/cureus.28640] [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] [Accepted: 08/31/2022] [Indexed: 11/05/2022] Open
Abstract
Langerhans cell histiocytosis (LCH) and adult-onset xanthogranuloma (AXG) are rare disorders characterized by the accumulation of macrophage, dendritic cells, or monocyte-derived cells in various tissues of the body. Many researchers now consider LCH a form of malignancy, but this classification remains controversial. As per our knowledge, there are only 36 cases of AXG reported so far in the English literature. Here, we report a case of AXG and single-system LCH found in the oral cavity and cervical lymph nodes, respectively. In this article, we intend to define a clear understanding of some classic clinical, radiological, and histopathological findings of LCH and AXG, to differentiate them from oral malignancies. The primary goal of this article is to increase awareness regarding conditions that closely resemble malignancies and to save patients from the burden of extensive treatment under the presumption of malignant disorders. In the medical field, reporting of rare cases is highly encouraged; however, proper treatment for the patient depends on the accurate diagnosis that, in this case, was made postoperatively, which only added more physical and mental distress for the patient and their family.
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Faustino ISP, Georgaki M, Fonseca FP, Martins MD, Santos-Silva AR, Vargas PA, Lopes MA. Intraoral mass, extraoral suppuration, and jaw lesions. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 134:10-14. [PMID: 34758944 DOI: 10.1016/j.oooo.2021.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/16/2021] [Accepted: 09/20/2021] [Indexed: 10/20/2022]
Affiliation(s)
| | - Maria Georgaki
- Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Manoela Domingues Martins
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Alan Roger Santos-Silva
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Marcio Ajudarte Lopes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Faustino ISP, Fernandes PM, Pontes HAR, Mosqueda-Taylor A, Santos-Silva AR, Vargas PA, Lopes MA. Langerhans cell histiocytosis in the oral and maxillofacial region: An update. J Oral Pathol Med 2021; 50:565-571. [PMID: 34091963 DOI: 10.1111/jop.13207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/02/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Langerhans cell histiocytosis (LCH) is a rare disorder characterized by abnormal proliferation and infiltration of histiocytic cells. METHODS This review focused on the main aspects associated with LCH. RESULTS LCH can involve single or multiple organs and systems, with bone and skin being the most commonly affected sites. Regarding skeletal manifestations, the jawbones are involved in about 20%-30% of all cases. Such lesions may present as unilocular or multilocular images mainly affecting the posterior mandible. Oral soft tissue lesions may also occur, with the gingiva and hard palate being the most frequently affected sites. CONCLUSION The diagnosis and management of LCH are challenging, requiring a multidisciplinary approach, with dentists playing a central role since oral manifestations can be the first sign of the condition.
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Affiliation(s)
| | - Patrícia Maria Fernandes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | | | | | - Alan Roger Santos-Silva
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Marcio Ajudarte Lopes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Cherian LM, Sasikumar D, Sathyan P, Varghese BE. Langerhans cell histiocytosis: A diagnostic enigma in the oral cavity. J Oral Maxillofac Pathol 2021; 25:S27-S31. [PMID: 34083966 PMCID: PMC8123262 DOI: 10.4103/jomfp.jomfp_296_20] [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: 07/15/2020] [Revised: 12/15/2020] [Accepted: 01/29/2021] [Indexed: 11/04/2022] Open
Abstract
Langerhans cell histiocytosis (LCH) is a rare reactive and proliferative disease of histiocytes. The disease occurs predominantly in children and rarely in adults. This disease of unknown etiology exhibits extreme clinical heterogeneity. Even though LCH manifests initially in the oral cavity in most of the cases, owing to the relative rarity of the condition, it remains a disease in which the diagnosis is often delayed, missed or misdiagnosed. This is a case of LCH in a child which presented with swelling in the mandibular region.
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Affiliation(s)
- Latha Mary Cherian
- Department of Oral Pathology and Microbiology, Government Dental College, Kottayam, Kerala, India
| | - Dhanya Sasikumar
- Department of Oral Pathology and Microbiology, Government Dental College, Kottayam, Kerala, India
| | - Pradeesh Sathyan
- Department of Oral Pathology and Microbiology, Government Dental College, Kottayam, Kerala, India
| | - Binuja Elsa Varghese
- Department of Oral Pathology and Microbiology, Government Dental College, Kottayam, Kerala, India
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Reisi N, Raeissi P, Harati Khalilabad T, Moafi A. Unusual sites of bone involvement in Langerhans cell histiocytosis: a systematic review of the literature. Orphanet J Rare Dis 2021; 16:1. [PMID: 33388073 PMCID: PMC7778820 DOI: 10.1186/s13023-020-01625-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 11/26/2020] [Indexed: 12/14/2022] Open
Abstract
Background Langerhans cell histiocytosis (LCH) is a rare disease that originates from the uncontrolled proliferation and accumulation of bone marrow-derived immature myeloid dendritic cells. Dendritic cells are a type of histiocyte that play an important role in the human immune system and are found in the bone, skin, stomach, eyes, intestines, and lungs.
Objective This systematic review aimed to collect and report published case reports of rare bone disease caused by LCH to avoid misdiagnoses or delays in diagnosis. Methods We systematically searched Scopus, PubMed, Embase, and Web of Sciences from August 1, 2000 to December 31, 2019. Studies reporting cases of LCH with rare bone involvement were included. Results We identified 60 articles including 64 cases. Of the identified cases, 31 (48.4%) involved children, and 33 (51.6%) involved adults. Additionally, 46.9% (30 individuals) were from Asian countries. The mean age of the children was 7.6 ± 4.3 years and that of the adults was 36 ± 12 years. The findings indicated that unifocal bone involvements were the most prevalent form of the disease (68.7%), and, overall, the skull and chest wall were the most commonly affected bones in both adults and children. The spine and long bones were the second most commonly affected bones in children, and the spine and jaw were the second most commonly affected bones in adults. Pain and swelling were the most frequent presenting signs among the investigated cases, and loss of consciousness, myelopathy, nerve palsy, visual loss, torticollis and clicking sounds were rare signs. Osteolytic lesions were the most frequent radiologic feature (62.5%), and intracranial hemorrhage, fluid–fluid level, dura and intracranial extension and pathologic fractures were rare radiological features. Total excision, curettage and observation in the unifocal group of patients and systemic chemotherapy in the other groups (i.e., multifocal and multisystem) were the most frequent management approaches. The recovery rates of the unifocal and multifocal groups were 77.3% and 81.8%, respectively, while that of the multisystem group was 55.5%. The rates of recurrence and mortality in the multisystem group were 11% and were higher than those in the other groups. Conclusions LCH is a rare disease that can affect any organ in the human body. However, bone is the most commonly involved organ, and rare bone involvements may be the first or only symptom of the disease due to the rarity of such lesions; a lack of familiarity with them may result in misdiagnosis or delayed diagnosis.
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Affiliation(s)
- Nahid Reisi
- Department of Pediatric Hematology and Oncology, Faculty of Medicine, Child Growth and Development Research Center and Isfahan Immunodeficiency Research Center, Seyed Al-Shohada Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Pouran Raeissi
- Department of Health Services Management, School of Health Management and Medical Information Science, Iran University of Medical Sciences, Tehran, Iran
| | - Touraj Harati Khalilabad
- Department of Health Economics, School of Health Management and Medical Information Science, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Moafi
- Department of Pediatric Hematology and Oncology, Faculty of Medicine, Child Growth and Development Research Center and Isfahan Immunodeficiency Research Center, Seyed Al-Shohada Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
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Solitary Hard Palate Langerhans Cell Histiocytosis Demonstrated on PET/CT Scan in an Adult. Clin Nucl Med 2020; 45:811-812. [PMID: 32804762 DOI: 10.1097/rlu.0000000000003248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Langerhans cell histiocytosis (LCH) is rare in adults. Oral and maxillofacial LCH commonly affects the bones of the skull and jaws. Here we report a case of a 57-year-old man with a painless oral mass evaluated by F-FDG PET/CT. PET/CT showed a solitary F-FDG-avid tumor in his left hard palate. LCH was confirmed after surgery. This case reminds us that LCH should be considered in an adult with hypermetabolic hard palate lesion on F-FDG PET/CT.
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Hammouri EH, Sweidan HA, AShokaibi O, Al Omari L. Langerhans cell histiocytosis: A case report with oral manifestations and the role of pediatric dentists in the diagnosis. Clin Case Rep 2020; 8:545-549. [PMID: 32185056 PMCID: PMC7069888 DOI: 10.1002/ccr3.2726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/23/2019] [Accepted: 12/24/2019] [Indexed: 12/14/2022] Open
Abstract
Langerhans cell histiocytosis (LCH) is a benign disease that behaves malignantly. Early recognition and treatment of oral manifestation of LCH by pediatric dentist and other medical specialties is important to prevent further organ damage.
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Atarbashi-Moghadam S, Lotfi A, Atarbashi-Moghadam F. Gingival recessions and ulcerations in association with pruritic papules of the scalp, hands, and trunk in a young adult female. Int J Dermatol 2019; 58:1253-1254. [PMID: 31183852 DOI: 10.1111/ijd.14482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 03/27/2019] [Accepted: 04/24/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Saede Atarbashi-Moghadam
- Department of Oral and Maxillofacial Pathology, Dental School of Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Lotfi
- Department of Oral and Maxillofacial Pathology, Dental School of Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fazele Atarbashi-Moghadam
- Department of Periodontics, Dental School of Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Wang YC, Li ZZ, Yin CY, Jiang LJ, Wang L. [Langerhans cell histiocytosis involving the oral and maxillofacial region: an analysis of 12 cases]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2019; 21:415-420. [PMID: 31104654 PMCID: PMC7389420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Indexed: 08/01/2024]
Abstract
OBJECTIVE To study the clinical features of Langerhans cell histiocytosis (LCH) involving the oral and maxillofacial region in children. METHODS A retrospective analysis was performed for the clinical data of 12 children with LCH involving the oral and maxillofacial region who were hospitalized and treated from September 2012 to September 2017, including clinical manifestations, pathological features, treatment and prognosis. RESULTS Of the 12 children, 8 (67%) had multiple system involvement and 7 (58%) had the involvement of organs at risk. Bone was the most common affected site (11 children, 92%), among whom 7 children had the involvement of the mandible. Oral soft tissue involvement manifested as gingival ulcer or hyperplasia in 4 children, loose teeth in 5 children, oral mucosal lesions in 2 children, and nodular lesions in 1 child. Pathological examination showed positive CDla in 11 children and positive CD207, CD68, S-100, and LCA in 12 children. Surgery combined with chemotherapy was the major treatment method, and surgical resection alone was performed for focal lesions. After treatment, 11 children were cured or improved and 1 gave up treatment and was lost to follow-up. No recurrence was observed. CONCLUSIONS LCH children with oral and maxillofacial involvement often have the involvement of multiple systems and organs at risk, with the mandible as the most common affected site. These children may also have the involvement of gingiva, oral mucosa and teeth. Surgery combined with chemotherapy is the major treatment method, and the patients generally have a good prognosis without recurrence.
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Affiliation(s)
- Ying-Chao Wang
- Department of Pediatric Hematology and Oncology, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China.
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Wang YC, Li ZZ, Yin CY, Jiang LJ, Wang L. [Langerhans cell histiocytosis involving the oral and maxillofacial region: an analysis of 12 cases]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2019. [PMID: 31104654 PMCID: PMC7389420 DOI: 10.7499/j.issn.1008-8830.2019.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
OBJECTIVE To study the clinical features of Langerhans cell histiocytosis (LCH) involving the oral and maxillofacial region in children. METHODS A retrospective analysis was performed for the clinical data of 12 children with LCH involving the oral and maxillofacial region who were hospitalized and treated from September 2012 to September 2017, including clinical manifestations, pathological features, treatment and prognosis. RESULTS Of the 12 children, 8 (67%) had multiple system involvement and 7 (58%) had the involvement of organs at risk. Bone was the most common affected site (11 children, 92%), among whom 7 children had the involvement of the mandible. Oral soft tissue involvement manifested as gingival ulcer or hyperplasia in 4 children, loose teeth in 5 children, oral mucosal lesions in 2 children, and nodular lesions in 1 child. Pathological examination showed positive CDla in 11 children and positive CD207, CD68, S-100, and LCA in 12 children. Surgery combined with chemotherapy was the major treatment method, and surgical resection alone was performed for focal lesions. After treatment, 11 children were cured or improved and 1 gave up treatment and was lost to follow-up. No recurrence was observed. CONCLUSIONS LCH children with oral and maxillofacial involvement often have the involvement of multiple systems and organs at risk, with the mandible as the most common affected site. These children may also have the involvement of gingiva, oral mucosa and teeth. Surgery combined with chemotherapy is the major treatment method, and the patients generally have a good prognosis without recurrence.
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Affiliation(s)
- Ying-Chao Wang
- Department of Pediatric Hematology and Oncology, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China.
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Sun HHB, Lin SC, Shimel B, Park CM, Sharaschandra S. Vascular Floor of Mouth Mass with Unanticipated Intracranial, Orbital, and Vertebral Associated Involvements. Head Neck Pathol 2019; 14:199-202. [PMID: 30758759 PMCID: PMC7021860 DOI: 10.1007/s12105-019-01017-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 01/24/2019] [Indexed: 10/27/2022]
Abstract
We report on a case in which a blanching, unobtrusive oral growth proved to be a systemic threat. A blind, epileptic child presented with a bleeding oral floor mass of 4 weeks. Biopsy showed small, dilated vascular spaces with reactive fibroblasts. MRI indicated distribution of expansile lesions in the mandible, cranial base, and right orbit that had possibly contributed to the patient's years-long neurologic deficits. A subsequent bone scan indicated lesions in multiple axial bones. Histologic markers confirmed the presentation of a rare cystic vascular pathology. Cystic Angiomatosis is a disease of intraosseous vascular malformations with occasional visceral involvements. Oral and craniomaxillofacial cases are especially rare and presentations can involve neuropsychiatric deficits, sensory issues, and mucosal bleeding. While clinicians are often dismissive of intraoral bleeding because of the prevalence of periodontal disease, careful evaluation is nonetheless critical to rule out underlying diseases with a possibly significant systemic involvement.
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Affiliation(s)
- Ho-Hyun Brian Sun
- grid.414076.00000 0004 0427 1107Division of Oral and Maxillofacial Surgery, Alameda Health System, Highland Hospital, 1411 E. 31st Street, Oakland, CA 94602 USA ,grid.254662.10000 0001 2152 7491University of the Pacific, Dugoni School of Dentistry, San Francisco, CA USA
| | - Sheng-Chuan Lin
- grid.414076.00000 0004 0427 1107Division of Oral and Maxillofacial Surgery, Alameda Health System, Highland Hospital, 1411 E. 31st Street, Oakland, CA 94602 USA ,grid.254662.10000 0001 2152 7491University of the Pacific, Dugoni School of Dentistry, San Francisco, CA USA
| | - Benjamin Shimel
- grid.414076.00000 0004 0427 1107Division of Oral and Maxillofacial Surgery, Alameda Health System, Highland Hospital, 1411 E. 31st Street, Oakland, CA 94602 USA
| | - Chan M. Park
- grid.414076.00000 0004 0427 1107Division Chief and Program Director, Division of Oral and Maxillofacial Surgery, Alameda Health System, Highland Hospital, Oakland, CA USA ,Irvine, CA USA
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