Pathological fracture of the mandible, secondary to eosinophilic granuloma in a medically compromised patient.

A case of eosinophilic granuloma of the mandible with submandibular lymph node involvement in a medically compromised patient is presented. The lesion caused the pathologic fracture of the. mandible. It was treated radically with the resection of the mandible between the angle posteriorly and the midline anteriorly and immediate reconstruction with a 3DBDB AO reconstruction plate. This was followed by telecobalt therapy of 2000 cGys in 10 fractions over 20 days.The combined surgical and radiation therapy should be reserved for patients having: (1) unremitting pain following currettage (2) Limitation of activity (3) a medically compromised patient or (3) in whom radiographic findings suggest an aggressive lesion involving adjacent tissues and/or causing pathologic fractures.