Diagnosis and management of eosinophilic granuloma of the jaw: a case report (original) (raw)
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Eosinophilic Granuloma of Mandible: A Diagnostic Challenge
Kathmandu University medical journal, 2018
Eosinophilic Granuloma is the mildest and localized form of Langerhans Cell Histiocytosis and is characterized by clonal proliferation of Langerhans cells. It is a rare disease, accounting for less than 1% of all the osseous neoplasms. It has predilection for the axial skeleton and incidence in jaws is just 7.9%. It lacks pathognomonic clinical and radiographic trait and hence is difficult to make a correct diagnosis without histopathological and immunohistochemical examination. This report describes a case of Eosinophilic Granuloma of mandible in 30 years old male who presented with complain of unhealed extraction wound and was clinically diagnosed as chronic suppurative osteomyelitis. The final diagnosis of Eosinophilic Granuloma was made only after histopathological and immunohistochemical evaluations.
2020
Most patients are children or adolescents but the disease can affect any age group, including the elderly [4]. It is classified into three clinical forms depending on the age and presentation: 1) Chronic focal Langerhans Cell Histiocytosis or Eosinophilic Granuloma this is the most frequent and benign of the three clinical forms which appears as a unifocal or multifocal lesion in single or multiple bones with or without soft tissue involvement presenting at any age. 2) Chronic diffuse LCH (Hand Schuller Christian Disease) which usually appears in children or young adults with the characteristic triad of Exophthalmos, Osteolytic lesions of cranium and Diabetes insipidus. Abstract Eosinophilic Granuloma represents one of a triad, of lesions encompassing a disease under the generic name Histiocytosis X or Langerhans Cell Histiocytosis. It is a benign inflammatory reaction to an unknown etiological agent and corresponds with bony lesions. The most commonly involved bones are the skull, ...
Solitary eosinophilic granuloma of the parietal bone in an adult patient
Neurosciences (Riyadh, Saudi Arabia), 2007
Eosinophilic granuloma (EG) is a well-recognized benign form of Langerhans-cell histiocytosis. The estimated incidence of EG is 3-4 per million of the population. More patients are children and adolescents between the ages of 1-15 years. In this report, we present an adult patient. A 37-year-old male was admitted with headache and right parietal swelling that was present for 2 months together with epileptic attacks. Cranial CT scan revealed a right parietal osteolytic lesion with large epidural and subcutaneous mass, causing brain compression. Total removal of the mass was carried out with cranioplasty. Histopathological examination disclosed Langerhans cell histiocytosis and immunohistochemical detection of S-100 antigen. At follow-up, he had no neurological deficits, and control CT was normal. For symptomatic solitary calvarial EG, surgical excision is the main treatment option. Surgical treatment is simple, quick, and allows histological diagnosis of the osteolytic lesions.
Background: Langerhans cell histiocytosis (LCH), previously known as Histiocytosis X, is an infrequent disease that congregates a wide spectrum of clinical presentations with variable systemic involvement. Unification of these diseases under only one category is based on the almost identical histopathologic features of the lesions, but the etiology and proper approach for each presentation remains controversial. The localized alternative of Langerhans cell histiocytosis (LLCH), known as Eosinophilic Granuloma (EG) of bone, is the predominant clinical presentation of LCH. The maxilla is involved in 1 % of the head and neck region cases, representing an uncommon condition in this area. Case Presentation: In this clinical case report, it is described a case of a 16-year-old male patient with an asymptomatic osteolytic lesion at first upper left molar apical level, a finding detected on control radiographic images was reported as " Monostotic Eosinophilic granuloma of the maxillary bone " , which was later confirmed through an incisional biopsy. A surgical excision was initially planned, but finally it was not performed due to a spontaneous healing of the lesion after the incisional biopsy. Conclusions: The presented case supports a conservative approach in the management of solitary EG of maxillary and mandibular bone lesions and even supports an expectant attitude in the course of treatment given the possibility of a spontaneous regression after the biopsy, especially in small lesions.