UNILATERAL EOSINOPHILIC GRANULOMA IN THE MANDIBULAR MOLAR REGION: A CASE REPORT
JULIANA MADUREIRA DE SOUZA LIMA ALONSO *
Faculty of Pindamonhangaba – FUNVIC - Christian Life University Foundation Pindamonhangaba, São Paulo, Brazil.
MÁRCIA HATAKEYAMA
Institute of Science and Technology, UNESP – Univ Estadual Paulista, São José dos Campos (SP) Brazil, Department of Biosciences and Oral Diagnosis, School of Dentistry, Brazil.
CRISTINA WERKMAN
Institute of Science and Technology, UNESP – Univ Estadual Paulista, São José dos Campos (SP) Brazil, Department of Biosciences and Oral Diagnosis, School of Dentistry, Brazil.
DANIELA MARTINS DE SOUZA
Faculty of Pindamonhangaba – FUNVIC - Christian Life University Foundation Pindamonhangaba, São Paulo, Brazil.
ROSILENE FERNANDES DA ROCHA
Institute of Science and Technology, UNESP – Univ Estadual Paulista, São José dos Campos (SP) Brazil, Department of Biosciences and Oral Diagnosis, School of Dentistry, Brazil.
YASMIN RODARTE CARVALHO
Institute of Science and Technology, UNESP – Univ Estadual Paulista, São José dos Campos (SP) Brazil, Department of Biosciences and Oral Diagnosis, School of Dentistry, Brazil.
*Author to whom correspondence should be addressed.
Abstract
The great similarity in the clinical, radiographic and microbiological features of oral manifestations observed in severe periodontal disease and bone lesions of Langerhans cells makes it necessary to get the correct differential diagnosis of these pathologies for proper treatment planning. An accurate diagnosis may result from biopsy and histopathological and/or immunohistochemical examinations using radiography as an important complementary examination. The current report presents the case of a 19-year-old male patient with history of Langerhans cells histiocytosis (LCH), who had been stable for four years and had lesion in the left lower molar tooth region showing the typical clinical feature of severe localized periodontal disease. After the periodontal treatments presented poor prognosis, the patient was indicated to incisional biopsy of the affected region in order to correctly diagnose the lesion. The histopathological diagnosis showed eosinophilic granuloma of bone and clinical diagnosis showed periodontal disease associated with systemic diseases. The patient was instructed to resume system treatment. Cases such as the herein presented one emphasize the need for an interdisciplinary approach to the diagnosis and treatment and the importance of dental follow-up in LCH patients.
Keywords: Langerhans cell histiocytosis, eosinophilic granuloma, histiocytosis X, periodontal disease, differential diagnosis