Desbarats C, Adnot J, Bastien A V, Trost O
Service de chirurgie maxillo-faciale et stomatologie, centre hospitalo-universitaire de Rouen, 1, rue de Germont, 76000 Rouen, France.
Service de chirurgie maxillo-faciale et stomatologie, centre hospitalo-universitaire de Rouen, 1, rue de Germont, 76000 Rouen, France; Laboratoire d'anatomie, faculté de médecine de Rouen, 22, boulevard Gambetta, 76000 Rouen, France; Institut national de la santé et de la recherche médicale (Inserm), LIMICS UMR-1142, 76000 Rouen, France.
Rev Med Interne. 2020 Jan;41(1):50-53. doi: 10.1016/j.revmed.2019.08.005. Epub 2019 Aug 29.
Langerhans cell histiocytosis (HL) is a rare disease that can affect all tissues. Oral manifestations such as mucosal ulcer and tooth mobility are often the first signs of the disease. We report a rare case of mandibular condyle unifocal HL mimicking a temporomandibular joint disorder.
A 44-year-old patient presented with a left temporomandibular disorder with painful left preauricular swelling. The imaging assessment found a bone lesion of the left mandibular condyle. A curettage with biopsy was used to diagnose HL. Six months later, the patient had no more pain.
The craniofacial clinical expressions of HL mainly concern the bones, which can cause: pain, swelling, fracture, compression of noble organs. The other sites are: oral cavity, skin, lymph nodes, or eyes. Isolated forms are generally benign, and their treatment is discussed between abstention and non-aggressive surgery.
朗格汉斯细胞组织细胞增多症（HL）是一种可累及所有组织的罕见疾病。口腔表现如黏膜溃疡和牙齿松动往往是该疾病的首发症状。我们报告一例罕见的下颌髁突单灶性HL，表现类似颞下颌关节紊乱病。
一名44岁患者出现左侧颞下颌关节紊乱，伴有左侧耳前疼痛性肿胀。影像学评估发现左侧下颌髁突有骨质病变。通过刮除术加活检诊断为HL。6个月后，患者不再疼痛。
HL的颅面临床表现主要涉及骨骼，可导致：疼痛、肿胀、骨折、重要器官受压。其他部位包括：口腔、皮肤、淋巴结或眼睛。孤立型通常为良性，其治疗方案在观察等待和非侵袭性手术之间进行讨论。
