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29 May 2009

Bifocal manifestation of eosinophilic granuloma in a pediatric patient

Rosario GuigliaABDEF, Giuseppe PizzoADEF, Maurizio AricòB, Emiliano MaresiB, Domenico CompilatoBF, Giuseppina CampisiAB

Med Sci Monit 2009; 15(6): CS95-99 :: ID: 869667

Abstract

Background
Eosinophilic granuloma (EG) is a clinical variant of the Langerhans cell histiocytosis (LCH) characterized by unifocal or multifocal bone lesions which predominantly affects children, adolescents, and young adults.
Material and Method
A case is reported of a 13-year-old Caucasian boy who presented unifocal EG in the mandible as the first clinic manifestation. Radiographic examination and skeletal scintigraphy revealed a further localization with an osteolytic lesion in the right femur. The therapeutic protocol used for the mandibular lesion included causal periodontal therapy, extraction of the compromised teeth, alveolar curettage, and intralesional injections of corticosteroids, in correspondence with femoral and mandibular bone lesions.
Results

Conclusions
Early diagnosis of LCH is considered an important factor which can improve the patient's prognosis and quality of life and also the cost-effectiveness of therapy. Dentists could play a fundamental role in the diagnosis and management of EG. The aim of the treatment is to eradicate EG lesions and provide adequate oral rehabilitation after the tooth loss. A careful multidisciplinary follow-up program is mandatory to identify any signs of local recurrence or dissemination.

Keywords: Osteolysis - radiography, Follow-Up Studies, Eosinophilic Granuloma - radiography, Bone Resorption - radiography, Adolescent

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