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

## TL;DR

A 75-year-old man with Langerhans cell histiocytosis in his jaw was successfully treated with surgery and local steroids, a novel approach for this rare disease in older patients.

## Contribution

This is the first reported case of successful treatment of mandibular LCH in an elderly patient using surgical resection and local steroids.

## Key findings

- Surgical resection combined with local steroids led to a favorable outcome in an elderly patient with LCH.
- The patient experienced pain improvement and wound healing within two months following treatment.
- Radiographic and pathological findings confirmed the diagnosis and treatment effectiveness.

## Abstract

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.

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.

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