Surgical management of recurrent oral manifestation of Langerhans Cell Histiocytosis: case report

Nayara Conceição Marcos Santana; João Ayres Schmitz; Renata de Caralho Lacerda; Henrique de Carvalho Lacerda; Sérgio Antonucci Amaral; Renata Gonçalves Resende; Júlio César Tanos de Lacerda

doi:10.5327/2525-5711.351

Authors

Nayara Conceição Marcos Santana Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil https://orcid.org/0000-0002-1220-6300
João Ayres Schmitz Service of Stomatology and Oral and Maxillofacial Surgery, Hospital Metropolitano Odilon Behrens, Belo Horizonte, Minas Gerais, Brazil. https://orcid.org/0009-0001-1116-8082
Renata de Caralho Lacerda School of Medicine, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. https://orcid.org/0000-0002-9258-3260
Henrique de Carvalho Lacerda 4School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. https://orcid.org/0000-0003-2430-8168
Sérgio Antonucci Amaral Department of Periodontology, School of Dentistry, Centro Universitário Newton Paiva, Belo Horizonte, Minas Gerais, Brazil https://orcid.org/0000-0002-7469-4135
Renata Gonçalves Resende Service of Stomatology and Oral and Maxillofacial Surgery, Hospital Metropolitano Odilon Behrens, Belo Horizonte, Minas Gerais, Brazil https://orcid.org/0000-0001-7610-0399
Júlio César Tanos de Lacerda Service of Stomatology and Oral and Maxillofacial Surgery, Hospital Metropolitano Odilon Behrens, Belo Horizonte, Minas Gerais, Brazil https://orcid.org/0000-0002-5570-3550

DOI:

https://doi.org/10.5327/2525-5711.351

Keywords:

Langerhans cell histiocytosis, Oral manifestations, Oral surgery, Recurrence, Case Report

Abstract

Langerhans Cell Histiocytosis (LCH) is a rare disease characterized by the abnormal proliferation of Langerhans cells, which can affect several tissues, including the oral cavity. This case report details the follow-up and treatment over 10 years of multiple recurrences. A 21-year-old female patient presented with tooth mobility and an osteolytic lesion in the mandible, diagnosed by incisional biopsy as LCH. Initially treated with surgical excision, the patient experienced a recurrence within less than a year and was subsequently managed conservatively with intralesional corticosteroid injection. However, conservative treatment was unsuccessful, and the patient underwent segmental resection of the mandible followed by bone fixation using plates and screws for reconstruction after a mandibular fracture. The patient later developed additional recurrences in other regions of the oral cavity, requiring further surgical interventions, along with systemic manifestations, which required chemotherapy for management. This case report shows the complexity of treatment and the importance of monitoring individuals with LCH by a multidisciplinary team.

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