title: Hand-Schüler-Christian disease presenting with recurrent, bilateral, symmetrical mandibular lesions in an 8-year-old boy: report of a case.
abstract: BACKGROUND
  Hand-Schüller-Christian disease (HSC) is the unisystem multifocal form of Langerhans Cell Histiocytosis (LCH) and is primarily seen in infants and children.
  
  
  METHODS
  An 8-year-old boy was referred for acute mandibular pain. His medical history included otic LCH and diabetes insipidus at age of 11 months. Intraorally, a pressure sensitive swelling, and radiographically, extensive bone loss were revealed on the area of lower second primary molars. The primary molars were extracted and histological examination confirmed the final diagnosis of HSC. The patient was treated with chemotherapy and the lesions decreased considerably. Two years later, a new swelling was recorded in the same area bilaterally. Biopsy confirmed recurrent HSC disease and the patient entered an alternative chemotherapy protocol. Six months later, improvement of the lesions was revealed.
  
  
  CONCLUSIONS
  Dentists can contribute to a timely and valid identification of HSC disease by correctly differentially diagnosing lesions of head and neck.
authors.affiliation: Assistant Professor of Paediatric Dentistry, School of Dentistry, University of Athens, Athens, Greece.
authors.forename: Dimitris
authors.initials: D
authors.lastname: Emmanouil
authors.affiliation: Postgraduate student of Oral Biology, School of Dentistry, University of Athens, Athens, Greece.
authors.forename: Eleftheria
authors.initials: E
authors.lastname: Birpou
authors.affiliation: Postgraduate student of Oral Biology, School of Dentistry, University of Athens, Athens, Greece.
authors.forename: Konstantina
authors.initials: K
authors.lastname: Chatzidimitriou
authors.affiliation: Paediatric dentist, School of Dentistry, University of Athens, Athens, Greece.
authors.forename: Chrysanthi
authors.initials: C
authors.lastname: Matsioula
authors.affiliation: Assistant Professor of Oral and Maxillofacial Surgery, School of Dentistry, University of Athens, Athens, Greece.
authors.forename: Panos
authors.initials: P
authors.lastname: Christopoulos
authors.affiliation: Assistant Professor of Oral Medicine and Pathology, School of Dentistry, University of Athens, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Tosios
mesh_terms: D001706:Biopsy; D003937:Diagnosis, Differential; D006646:Histiocytosis, Langerhans-Cell / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007223:Infant; D008297:Male; D008336:Mandibular Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D011862:Radiography, Panoramic
keywords: Hand-Schüller-Christian disease; bilateral; chemotherapy; children; mandible; oncology