Langerhans cell histiocytosis in a child: a 10-year follow-up

This report describes a case of the benign form of Langerhans cell histiocytosis, which involves only the maxilla and mandible, and has no extraskeletal manifestations.

A 2.9-year-old boy was referred to a paediatric dentistry clinic, where clinical, radiographic and histological findings were found to be consistent with Langerhans cell histiocytosis. The difficulties involved in the diagnosis and the subject's functional oral rehabilitation are described. In view of the presence of large bone lesions, systematic treatment consisted of oral chemotherapy and the administration of methylprednisolone by intralesional infiltration. Oral examination revealed complete resolution of the ulcerative lesions. The soft tissue appeared healthy and had a normal colour. There was no tooth mobility and radiography provided evidence of bony healing.

This case is particularly interesting because follow-up clinical and radiographic observations have been made over the past 10 years. The successful treatment had several objectives, including providing the patient with an aesthetic appearance and recovering the lost vertical dimension of occlusion.