Journal of Korean Dental Science

Korean Academy of Dental Science (대한치의학회)
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Treatment and Rehabilitation of Repetitively Recurrent Langerhans Cell Histiocytosis: A Case Report

  • Yoo, Hee Young (Department of Oral and Maxillofacial Surgery, Graduate School, Kyung Hee University) ;
  • Park, Kyung Soo (Department of Oral and Maxillofacial Surgery, Graduate School, Kyung Hee University) ;
  • Lee, Baek Soo (Department of Oral and Maxillofacial Surgery, Graduate School, Kyung Hee University) ;
  • Kwon, Yong Dae (Department of Oral and Maxillofacial Surgery, Graduate School, Kyung Hee University) ;
  • Choi, Byung Joon (Department of Oral and Maxillofacial Surgery, Graduate School, Kyung Hee University) ;
  • Ohe, Joo Young (Department of Oral and Maxillofacial Surgery, Graduate School, Kyung Hee University) ;
  • Lee, Jung Woo (Department of Oral and Maxillofacial Surgery, Graduate School, Kyung Hee University)
  • Received : 2016.01.04
  • Accepted : 2016.06.01
  • Published : 2016.06.30
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Abstract

Langerhans cell histiocytosis (LCH) is characterized by proliferation of histiocyte-like cells (Langerhans cell histiocytes) with characteristic Birbeck granules, accompanied by other inflammatory cells. Treatments of LCH include surgery, chemotherapy, and radiotherapy. One of the representative forms of chemotherapy is intralesional injection of steroids. Surgical treatment in the form of simple excision, curettage, or even ostectomy can be performed depending on the extent of involvement. Radiotherapy is suggested in case of local recurrence, or a widespread lesion. This article shows the case of repetitively recurrent LCH of a 56-year-old man who had been through surgical excision and had to have marginal mandibulectomy and radiotherapy when the disease recurred. After the first recurrence occurred, lesions involved the extensive part of the mandible causing pathologic fracture, so partial mandibular bone resection was performed from the right molar area to the left molar area followed by the excision of the surrounding infected soft tissues. The resected mandibular bone was reconstructed with a segment of fibula osteomyocutaneous free flap and overdenture prosthesis supported by osseointegrated implants.

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