Solitary eosinophilic granuloma in the ramus and condyle of the mandible report

Abstract

Objectives: Eosinophilic granuloma is the most common lesion in the spectrum of disorders under the classification of Langerhans’ cell histiocytosis. Eosinophilic granuloma represents the monostotic form of the disease with the head and neck region representing the most common site of initial presentation. While up to 60% of cases may present with temporal bone involvement, only rarely does it present with primary mandibular ramus and/or condyle involvement. Involvement of the mandibular condyle and ramus may preclude primary surgical resection or curettage. Methods: An 11-year-old boy presented with a 5-week history of progressively worsening right jaw pain, swelling, and trismus without otalgia, tooth pain, or numbness. A panorex and CT scan were completed. Results: The panorex and CT scan revealed a radiolucent mass causing local destruction of the ramus and condyle of the right hemimandible. A transoral approach was used to obtain definitive tissue diagnosis. Conclusion: Eosinophilic granuloma presenting in the ramus of the mandible is very rare and may escape early detection due to lack of odontogenic involvement. A transoral approach was successful in obtaining adequate tissue for diagnosis. This entity should be considered in the differential diagnosis of unilateral jaw or TMJ pain. Relevant head and neck manifestations, histology, and treatment options of eosinophilic granuloma will be discussed.