The Impact of Hybrid Therapy on Langerhans Cell Histiocytosis of the Mandible in an Older Male: A Case Report and Literature Review.

BACKGROUND: The unusual disorder known as Langerhans cell histiocytosis (LCH), which is most frequently observed in children and young adults, is caused by the clonal proliferation of Langerhans cells. This disease is classified into several types depending on the extent of the lesion. Because it is rare diseases, there is no established standard treatment of this disease. In this report, we describe an extremely rare case of LCH that developed in the mandible of an older male. This is the first report in the world of a favorable outcome following surgical resection and local steroids administration.

CASE REPORT: The patient was a 75-year-old male who complained of swelling and pain in his mandible; however, there were no abnormal findings upon intraoral examination. Panoramic radiograph, computed tomography (CT), and magnetic resonance imaging (MRI) revealed osteolytic tumors. A diagnosis of LCH was confirmed based on the pathological findings of a cluster of Langerhans cells in a biopsy specimen of a submucosal tumor. Because the patient was elderly and the primary tumor was in the mandible, radiation therapy, chemotherapy, and systemic steroid administration were difficult to tolerate due to side effects. We performed combined treatment with surgical resection and local steroids injection. He was discharged from the hospital 1 week after the operation; the intraoral wound healed after 2 months, and the pain improved.

CONCLUSIONS: This report suggests that a combination of surgical resection and local steroids administration is effective in treating LCH of the mandible in elderly patients.