Langerhans cell histiocytosis (LCH) is a neoplastic proliferation of Langerhans cells. Its incidence is less than 1% of all bone lesions and occurs more frequently in people under 30 years old, affecting mostly males. It can affect any bone of the human body showing predilection for the skull, causing pain, swelling and dysfunction. Radiographically, it appears as a radiolucent lesion with characteristics of being locally aggressive. According to its clinical course, prognosis and treatment, three different clinical presentation are considered, known as: eosinophilic granuloma (EG), Hand–Schuller–Christian disease and Letterer–Siwe disease, which share the same histopathological pattern. Both, the Hand–Schuller–Christian disease and Letterer–Siwe disease are related to processes of acute and multisystemic involvement, usually with fatal outcome. The EG is the most benign and localized form of LCH. The lesions may appear as solitary or multiple, presenting monostotic or polyostotic affectation. When the jaw are compromised, is located preferably in the molar area and angle of the mandible and may present paresthesia, oral ulcers and pathological tooth mobility. Sometimes it can be clinically confused with acute inflammatory periodontal disease.
Two male patients are presented and diagnosed with LCH, eosinophilic granuloma type, treated between 2008 and 2010 in the maxillofacial surgery department of Hospital Dr. Gustavo Fricke, Viña del Mar, Chile. Reports on the diagnostic process, the multidisciplinary approach, treatment alternatives used and their subsequent monitoring are discussed.
Conflict of interest: None declared.