Oral manifestation and gingival biopsy contributing to the early diagnosis of Langerhans cell histiocytosis in a paediatric patient.

INTRODUCTION

Langerhans cell histiocytosis (LCH) is a myeloid dendritic cell neoplasm causing inflammation and tissue destruction. Clinical features vary from single bone involvement to a multi-system, life-threatening disease.

CASE PRESENTATION: A 3-year-old presented with bilateral osteolytic lesions, advanced alveolar and basal bone loss, widened inferior alveolar canal, and displacement of tooth buds. Clinical findings revealed the presence of multiple ulcerative lesions on the gingival region of the mandibular posterior teeth, the palatal region of the maxillary posterior teeth, and the right submandibular lymphadenopathy with cranial pain. Patient's family history revealed a sibling with multiple osteolytic lesions, and systemic symptoms. Histopathologic examination demonstrated infiltration by S100-CD1a-positive histiocytes accompanied by eosinophils, consistent with LCH.

CONCLUSION

This case report outlines the difficulties in early diagnosis of jaw lesions, their differential diagnosis, and early biopsy to guide multidisciplinary management.