Treatment and Rehabilitation of Repetitively Recurrent Langerhans Cell Histiocytosis: A Case Report.
- Author:
Hee Young YOO
1
;
Kyung Soo PARK
;
Baek Soo LEE
;
Yong Dae KWON
;
Byung Joon CHOI
;
Joo Young OHE
;
Jung Woo LEE
Author Information
- Publication Type:Case Report
- Keywords: Fibula osteomyocutaneous free flap; Histiocytosis, Langerhans cell; Reconstruction; Recurrence
- MeSH: Curettage; Denture, Overlay; Drug Therapy; Fibula; Fractures, Spontaneous; Free Tissue Flaps; Histiocytosis, Langerhans-Cell*; Humans; Injections, Intralesional; Mandible; Middle Aged; Molar; Prostheses and Implants; Radiotherapy; Recurrence; Rehabilitation*; Steroids
- From:Journal of Korean Dental Science 2016;9(1):35-41
- CountryRepublic of Korea
- Language:English
- 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.