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Medical Science Monitor Basic Research


Incidental Diagnosis on Orthopantomography of Langerhans Cell Histiocytosis with Multifocal Jaw Involvement: A Case Report of Single-System Disease

Unusual clinical course, Challenging differential diagnosis

Amr S. Bugshan, Mohammed A. Alsaati, Faiyaz A. Syed, Khalid S. Almulhim, Adel I. Abdulhady

Saudi Arabia Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia

Am J Case Rep 2020; 21:e928307

DOI: 10.12659/AJCR.928307

Available online: 2020-10-13

Published: 2020-11-24


BACKGROUND: Langerhans cell histiocytosis (LCH) is a relatively rare neoplasm with a strong inflammatory component. It has diverse clinical manifestations, which range from a single lesion or multiple bony lesions to severe multisystem involvement. Approximately 10% to 20% of cases of LCH occur in the jaw, with the posterior mandible being the site most frequently involved.
CASE REPORT: We report on the case of a 42-year-old man who presented with bilateral osteolytic lesions in the posterior mandible that were incidentally discovered during routine radiographic screening. Histological examination of the specimen confirmed the diagnosis of LCH.
CONCLUSIONS: This case illustrates the importance of orthopantomography (OPG) as a screening tool in new patients to perform an overall evaluation of the teeth and surrounding structures, such as the bone, temporomandibular joint, and sinuses. Moreover, OPG can be used to screen for the presence of asymptomatic lesions that are often diagnosed incidentally on radiographs.

Keywords: Diagnosis, Oral, Histiocytosis, Jaw Diseases, Langerhans cells, Osteolysis