Langerhans Cell Histiocytosis Involving the Maxilla and Mandible - A Case Report.

Rationale: Langerhans cell histiocytosis (LCH) is a rare disease involving neoplastic proliferation of myeloid precursor cells, primarily affecting bones such as ribs, pelvis, femur, and mandible with rare simultaneous involvement of the maxilla and mandible.

Patient concerns and diagnosis: A 48-year-old male presented with swelling and tooth mobility since 6 months. Orthopantomogram revealed extensive destruction in the mandible and right maxillary posterior region. Histological examination confirmed LCH using immunohistochemical staining with S-100, CD1a.

Treatment: As patient refused of surgery, intralesional methylprednisolone injections were selected as non-invasive treatment approach for localized LCH.

Outcome: Three months post-treatment, remission was observed, though some residual lesion remained. Follow-up at six months showed no further disease progression, supporting the efficacy of corticosteroid injections.

Take-away lessons: Treatment should be based on the diagnosis of LCH along with the extent of involvement of bones. Based on review of the literature and our own findings, intralesional corticosteroids were found to be effective for localized LCH.