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LCH of Oral Cavity

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Langerhans Cell Histiocytosis (LCH) of Oral Cavity: Oral lesions are fairly common in LCH and occur either as unifocal disease or as a component of multisystem disease. Oral manifestations appear early and may predate other evidence of the disease by several years. The patients are usually children (1-5 yr. age group)

The lesions are found on gingiva or hard palate and develop in the context of lytic bone lesions of mandible or maxilla. Oral soft tissue lesions without bone involvement are rare. Oral manifestations include gingivitis, periodontitis, tooth loss or rotation, hypermobile teeth (floating teeth), and malocclusion.

On imaging, the lesions appear as sharply punched-out radiolucent areas. In mandible, the location is usually posterior areas. Severe bone loss around teeth may cause an appearance of floating teeth.

About this image: This 2-yr old boy with LCH presented with oral ulcers, bleeding gums, and difficulty eating. He had destructive radiolucent lesions in mandible and maxilla with soft tissue component. Note the unevenly placed, malrotated teeth.

Image source: Eman Hussein Hammouri et al. Langerhans cell histiocytosis: A case report with oral manifestations and the role of pediatric dentists in the diagnosis. Clin Case Rep. 2020;8:545-549; image cropped and used under Creative Commons Attribution 4.0 International License.

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